CSM患者高位颈脊髓DTI参数与霍夫曼征关系的临床研究  

Clinical study on the relationship between DTI parameters of high cervical spinal cord and Hoffman sign in patients with CSM

作　　者：金韦明 陈森林 李威 巫贤勇 常建超 刘小琴 宋斾文 董福龙[1] Jin Weiming;Chen Senlin;Li Wei(Dept of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院骨科,合肥230022 [2]安徽医科大学第一附属医院放射科,合肥230022

出　　处：《安徽医科大学学报》2021年第12期1970-1975,共6页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校自然科学研究项目重点项目(编号:KJ2019A0275);安徽医科大学校科研基金(编号:2020xkj175);安徽医科大学第一附属医院临床研究启动计划项目(编号:LCYJ2021YB018)。

摘　　要：目的探究脊髓型颈椎病(CSM)患者Hoffman征阳性的发生机制。方法对88例CSM患者(Hoffman征阳性50例、阴性38例)及30例健康对照组进行DTI分析研究。在高位颈脊髓水平(C1-C3)内选取网状脊髓束、薄楔束、皮质脊髓前束和侧束在区域为感兴趣区,分析各组内、组间不同传导束区DTI参数是否存在有统计学意义的差异。结果CSM患者高位颈脊髓同一平面内不同传导束区DTI参数比值间差异有统计学意义(P<0.05);与Hoffman征阴性组及健康对照组相比,Hoffman征阳性组在皮质脊髓束区表现出更低的FA比值与更高的ADC比值(P<0.05)。结论Hoffman征阳性的出现与皮质脊髓束的损害有关联。对于Hoffman征阳性的CSM患者,在远离损害部位的高位颈脊髓水平,脊髓微结构的损害已发生。Objective To explore the mechanism of positive Hoffman sign in patients with cervical spondylosis myelopathy(CSM).Methods DTI analysis was performed in 88 patients with CSM(50 positive and 38 negative with Hoffman sign)and 30 healthy controls.In the high cervical spinal cord level(C1-C3),the reticular spinal tract,thin wedge tract,anterior corticospinal tract and lateral tract were selected as the regions of interest,and it was analyzed whether the DTI parameters of different conduction tract areas within and between groups were statistically significant.Results There was a significant difference in the ratio of DTI parameters in different conduction tract areas of the high cervical spinal cord in patients with CSM.Compared with the Hoffman sign negative group and the healthy control group,the Hoffman sign positive group showed lower FA ratio and higher ADC ratio in the corticospinal tract area(P<0.05).Conclusion The occurrence of Hoffman sign is related to the damage of corticospinal tract.For CSM patients with positive Hoffman sign,the microstructural damage of the spinal cord has occurred at the high level of the cervical spinal cord far from the lesion.

关 键 词：脊髓型颈椎病 弥散张量成像 霍夫曼征 表观弥散系数 各向异性分数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R687.1[医药卫生—诊断学]