不同体位颈椎MRI对平山病的影像诊断

Different Positions Cervical MRI Diagnosis of Hirayama Disease

目的探讨平山病患者自然位和前屈位颈椎MRI表现及其诊断价值。资料与方法对6例经临床确诊的平山病患者及6名正常自愿者均行颈椎自然位+前屈位+增强MRI,对比分析平山病患者低位颈髓的MRI表现。结果自然位:6例患者颈椎生理曲度变直,低位颈髓变细;6名正常自愿者可见颈膨大(约脊髓C6～T2段)。前屈位:6例患者低位颈髓变扁、萎缩,两种体位低位颈髓前后径差值与正常自愿者相比差异有统计学意义(P<0.05),另可见背侧硬膜囊后壁前移、硬膜外间隙增宽,内见迂曲、条形流空信号,增强后明显强化;正常自愿者低位颈髓较自然位略变细,背侧硬膜囊无前移、扩张,其内未见流空信号。结论不同体位MRI均能显示平山病患者颈椎的异常表现,尤其是前屈位对平山病的诊断具有重要价值。

Objective To analyze the MRI features of Hirayama disease with cervical neutral and flexion position. Materials and Methods The pre and post contrast neural and flexion position cervical MRI examinations were performed in 6 patients of Hirayama disease and 6 normal volunteer, which were evaluated for the changes of lower cervical. Results Neutral position：All 6 patients had abnormal cervical curvature and lower cervical cord atrophy compared with cervical enlargement （C6 -T2 ） in six control subjects. Flexion position： Hirayama patients had localized lower cervical cord atro- phy, asymmetric cord flattening, anterior shifting of the posterior wall of the cervical dural canal, epidural spacing widening in which there were distorting or stripe flow void signals with enhancement. Controls had no that phenomenon with lower cervical cord thinning. There were many differences between patients and controls about the changes of the anterior-posterior diameter of the cervical cord in two positions（P 〈 0.05）. Conclusion Different positions MR imaging, especially flexion MRI have significant values for the diagnosis of Hirayama disease.