颈椎过屈位磁共振成像在平山病诊断中的应用

Fully Flexed Position Cervical MRI for Diagnosis of Hirayama Disease

目的:研究颈椎过屈位MRI对平山病诊断的价值。材料和方法:对13例临床确诊为平山病的患者和10例正常对照者进行颈椎过屈位MRI矢状面和轴面扫描,观察低位脊髓萎缩、变扁、C6椎体上缘水平颈髓前后径及硬膜外异常信号。结果:①低位颈髓的萎缩:病例组9例(69%),对照组1例(10%)。②低位脊髓变扁:仅见于病例组11例(84%),其中有10例(77%)为不对称变扁,脊髓呈"梨形",1例(7%)呈三角形变扁。对照组未出现脊髓变扁的表现。③C6水平颈髓前后径与对照组相比明显变窄,差别有统计学意义(t=-4.54,P<0.05)。④低位颈椎椎管内硬膜后方T_2WI异常信号:仅见于患者组的10例(77%)。结论:颈椎过屈位MRI对诊断平山病有重要的价值。

Purpose： To explore the value of fully flexed position cervical MRI in the diagnosis of Hirayama disease. Materials and Methods： MRI examinations in fully flexed neck position were performed on 13 cases of Hirayama disease and 10 young male normal control subjects. Patients and subjects were evaluated for localized lower cervical cord atrophy, asymmetric cord flattening , crescent - shaped high - intensity mass with longitudinally curvilinear flow void signals appeared in the posterior epidural space . We measured anterior - posterior diameter of the cervical cord at the superior margin of the C6 vertebral body. The group means were compared by independent-sample t - test. Significance was defined as P 〈 0.05. Results： （1）There were significant difference of localized lower cervical cord atrophy （9 cases（69%） of patients group, 1 case of subjects group）, asymmetric cord flattening（ll cases（84% ） of patients and none of subjects）, Crescent - shaped high - intensity mass in the posterior epidural space（10 cases（77% ） of patients and none of subjects ）. （2） Anterior - posterior diameter of the cervical cord of patients and controls were（5.02 ± 0. 6） and（6.02 ± 0. 2） （ t = - 4.54, P 〈 0.05）. There were significant difference between patients and controls . Conclusion： There are obviously values of the fully flexed position cervical MRI for the diagnosis of Hirayama disease.