青少年颈椎病影像学特征及检查方法评价

Imaging characteristics of juvenile cervical vertebropathy and the evaluation of different imaging methods in its diagnosis

目的总结青少年颈椎病的影像学特征,并对检查方法进行综合分析与评价。方法回顾性分析经临床确诊并均行X线、CT、MRI检查的87例30岁以下青少年颈椎病患者的影像学表现。结果青少年颈椎病具有以下特征:(1)生理曲度改变。最为多见,主要表现为生理弯曲度前突加大或减少、消失变直、后凸或成角、侧弯等改变。(2)颈椎失稳。表现为椎体移位或滑脱,于侧位可见椎体后缘双重影像即"双边征"。(3)退行性改变。较为少见,表现为椎小关节退变、韧带钙化、椎间孔狭窄、椎间隙变窄、椎体骨质增生等。(4)CT可见软性椎间盘突出、椎间韧带肥厚、小关节囊肥大、钩椎关节增生等。(5)MRI还可发现X线和CT未能发现的早期椎间盘变性引起的信号异常改变。结论青少年颈椎病具有典型的影像学特征。其中X线检查是最基本的检查方法,能发现颈椎的大多数异常改变;CT可直接观察到椎间盘及侧隐窝的情况,能准确作出诊断,其灵敏度明显优于X线平片;MRI对椎间盘的早期信号异常改变能直观显示,对颈椎病的的分型具有较高的诊断价值。

Objective To summarize imaging characteristics of juvenile cervical vertebropathy, and to evaluate the different imaging methods in its diagnosis. Methods A retrospective analysis of the imaging features of 87 cases of clinically diagnosed juvenile cervical vertebropathy under age of 30 years seen recently in our hospital was performed. All cases received with X-ray, CT and MRI examinations. Results The imaging features of juvenile cervical vertebropathy had following characteristics ： （ 1 ） The change of physiological curve is one of the most common. It mainly presented as over-curvature, hypo-curvature, the straightened cervix, backward curvature, multiple curvatures and other change; （2）instable cervical spine. It mainly presented as displacement, olisthy, and the dual images of the posterior edge of vertebral body or ＂double contour sign＂ ; （3） Degenerative changes were relatively seldom among juvenile cervical vertebropathy. It mainly presented as intervertebral joint degeneration, ligament calcification, stenosis of foramen intervertebrale,joint space narrowing or formation of osteophyte; （4）Characteristic CT features included disc Herniation, ligament hypertrophy, hypertrophy of the facet joint capsule, hyperplasia of uncovertebral joint ; （5） MRI could early find abnormal signal changes of the intervertebral disc degeneration than X-ray and CT. Conclusion The imaging of juvenile cervical vertebropathy has typical characteristics. The X-ray is the most basic of the examination method, it can find most of abnormal changes of cervical vertebrae. Juvenile cervical vertebropathy were better shown by CT than by plain film ; MRI could early find abnormal signal changes of the intervertebral disc degeneration, MRI is of higher vaue for the typing of cervical vertebropathy.