磁共振弥散张量成像对轻度脊髓型颈椎病的诊断价值

Diagnosis value of DTI in cervical spondylosis in early stages

目的探讨3.0T磁共振DTI技术对无信号改变脊髓型颈椎病的诊断价值。方法选择21例健康志愿者作为对照组和42例无T2信号改变的脊髓型颈椎病患者行颈髓DTI成像,根据患者有无颈椎病体征将其分为阴性体征组(A组)和阳性体征组(B组)。分析各组表观弥散系数(ADC)、分数各向异性值(FA)、平行于颈髓长轴、前后径和左右径本征值1λ、2λ、λ3值的变化。结果所有受检者DTI成像显示满意。对照组颈髓平均ADC值为(0.78±0.08)×10-3mm2/s,FA值为0.72±0.03,λ1、2λ、λ3值分别为(1.51±0.15)×10-3、(0.42±0.09)×10-3、(0.41±0.10)×10-3mm2/s。A组FA值大于B组(P<0.01),B组ADC、1λ、λ2、λ3值均大于A组(P<0.05);对照组与A组比较,ADC、FA、λ1值无统计学差异(P>0.05),A组λ2、λ3值大于对照组(P<0.05);对照组FA值大于B组(P<0.01),B组ADC、λ2、λ3值大于对照组(P<0.05),而对照组和患者组间λ1值无统计学差异(P>0.05)。结论ADC、FA、λ1、λ2、λ3值是检测脊髓型颈椎病早期颈髓微结构改变的敏感指标。

Objective To evaluate the diagnosis value of diffusion tensor imaging （DTI） in cervical spondylosis without high signal intensity on the compression sites. Methods Twenty-one healthy volunteers and 42 patients with cervical spondylesis without high signal intensity on the T2WI were subjected to DTI by using a 3.0T MR scanner. Forty.-two patients were divided into 2 groups based on having or not having cervical spondylosis symptoms. Patients in group A had symptoms of cervical spondylosis while patients in group B did not. ADC, FA, λ1,λ2 and λ3 values were analyzed with a software package of SPSS 11.0. Fiber tracking was performed on examinees with Functool software of the GE Company. Results High quality ADC maps, FA maps and fiber tracking of cervical spinal cords were obtained. For healthy subjects, average ADC, FA, λ1, λ2 and λ3 values were （0.78± 0.08） ×10^-3 mm2/s, 0.72 ± 0.03, （1.51 ± 0.15） × 10^-3mm2/s, （0.42 ± 0.09） × 10^-3mm2/s and （0.41± 0.10）× 10^-3 mm2/s respectively. The FA value of group A was higher than that of group B（ P 〈 0. 01 ）, while values of ADC, FA, λ1, λ2 and λ3 of group B were higher than those of group A（ P 〈 0.05）. The ADC, FA and λ1 values were not statistically significant between group A and the control group（ P 〉 0.05）, while values of λ2 and λ3 of group A were higher than those of the control group（ P 〈 0.05）. The FA value of the control group was higher than that of group B（ P 〈 0.01）, and the ADC, λ2 and λ3 values of group B were higher than those of the control group （P 〈 0.05）, while there were no statistically significant differences between group B and the control group（ P 〉 0.05）. Conclusion The ADC, FA, λ1, λ2 and λ3 values are sensitive indices for evaluation of the subtle structure of cervical spinal cords which can be quantitatively analyzed by DTI in the early stage of cervical spendylosis.