非共用激励扩散加权成像技术对脊髓型颈椎病的诊断价值  

Diagnostic value of cervical spine non-shared incentive diffusion weighted imaging technique in cervical spondylotic myelopathy

作　　者：李佳[1] 张力 张玉金 张迪[3] 田笑楠 LI Jia;ZHANG Li;ZHANG Yujin;ZHANG Di;TIAN Xiaonan(CT Room,the Third Hospital of Hebei Medical University,Shijiazhuang 050039,China;Department of Radiology and Nuclear Medicine,the First Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Spinal Surgery,the Third Hospital of Hebei Medical University,Shijiazhuang 050039,China)

机构地区：[1]河北医科大学第三医院CT室,河北石家庄050039 [2]河北医科大学第一医院放射与核医学科,河北石家庄050000 [3]河北医科大学第三医院脊柱外科,河北石家庄050039

出　　处：《实用放射学杂志》2024年第1期6-10,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(82072454);河北省卫生健康委员会科研基金项目(20221190)。

摘　　要：目的探讨颈椎非共用激励扩散加权成像(ZOOM-DWI)技术在脊髓型颈椎病(CSM)诊断的应用价值。方法选取CSM患者49例(患者组),招募50例健康志愿者(对照组)。受试者均行颈椎常规MRI及ZOOM-DWI检查,CSM患者行神经功能改良日本骨科协会(mJOA)评分。测量患者组受压最狭窄处(C5~C6)椎间盘脊髓表观扩散系数(ADC)值、上下各1个节段椎间盘脊髓ADC值、C2~C3椎间盘脊髓ADC值;测量对照组C2~C3、C3~C4、C4~C5、C5~C6、C6~C7各层面ADC值。患者组及对照组各节段ADC值组内比较使用方差分析及两两事后比较(SNK-q);将患者组最狭窄处与对照组ADC值进行独立样本t检验;患者C5~C6ADC值与mJOA评分进行Pearson相关分析。结果对照组不同层面ADC均值无显著差异。患者组各测量层面ADC值,除C4~C5与C6~C7差异无统计学意义外,其余两两比较差异均有统计学意义(F=24.368,P<0.001),其中C5~C6ADC值最高。患者组C5~C6ADC值较对照组ADC值显著升高,差异有统计学意义(t=9.414,P<0.001);患者狭窄处ADC值与mJOA评分呈显著负相关(r=-0.493,P<0.001)。结论颈椎ZOOM-DWI技术可应用于诊断CSM,脊髓ADC值可作为诊断CSM的可靠影像学数据。Objective To investigate the clinical application value of the non-shared incentive diffusion weighted imaging(ZOOM-DWI)technique at cervical level in diagnosis of cervical spondylotic myelopathy(CSM).Methods A total of 49 CSM patients(patient group),and 5o healthy volunteers(control group)were recruited.All subjects underwent conventional MRI and ZOOM-DWI of the cervical spine and neurologic modified Japanese Orthopaedic Association(mJOA)scores in patients with CSM.The apparent diffusion coefficient(ADC)value in the spinal cord at the narrowest area(C5-C6)of the compression site of patients,the ADC value at the disc level in each upper and lower level,and the spinal ADC value at the cervical level C2-C3 were measured.The ADC values of control group C2-C3,C3-C4,C4-C5,C5-C6,C6-C7 were measured.Within-group comparisons of the spinal cord ADC values for each segment between patient and control groups were performed using analysis of variance and post hoc comparisons(SNK-q).The ADC values at the narrowest point of the patient group and control group were tested by independent sample t-test.The Pearson correlation analysis was performed between patients'C5-C6 ADC values and mJOA scores.Results The mean ADC values showed no significantly different levels in the control group.Among the ADC values at each measurement level in the patient group,except for C4-C5 and C6-C7 where the difference was not statistically significant,the remaining pair-wise comparisons all showed statistically significant differences(F=24.368,P<0.001),with the highest ADC value at C5-C6.The C5-C6 ADC value in the patient group was significantly higher compared to the control group(t=9.414,P<0.001),with statistical significance.The ADC values at the patient stenosis showed a significant negative correlation with the mJOA score(r=-0.493,P<0.001).Conclusion Cervical ZOOM-DWI technique can be applied to diagnose CSM,and spinal ADC values can be used as reliable imaging data for diagnosing CSM.

关 键 词：脊髓型颈椎病 扩散加权成像 表观扩散系数 改良日本骨科协会评分 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]