脊髓型颈椎病MRI-T_2WI髓内高信号与临床预后的相关研究

The Correlation of the Clinical Prognosis of Patients with Cervical Spondylosis Myelopathy and the Intramedullary High Signs on T_2WI MRI

目的探讨脊髓型颈椎病MRI-T2WI髓内高信号与临床预后的关系。方法将2009年7月至2011年7月诊治的57例脊髓型颈椎病患者根据MRI-T2WI髓内高信号不同分为MRI-T2WI无髓内高信号、髓内高信号模糊境界不清、髓内高信号明亮清晰境界清楚3组进行研究,对患者的年龄、病程、术前JOA评分、脊髓压缩比进行比较,随访时给予术后JOA评分并计算术后改善率,探讨髓内高信号对脊髓型颈椎病患者预后的指导意义。结果 57例患者中34例(59.65%)出现髓内高信号,其中髓内高信号模糊境界不清者18例,髓内高信号明亮清晰境界清楚者16例。脊髓型颈椎病不伴髓内高信号或伴髓内高信号模糊境界不清的患者术后改善率较高,手术效果较好;脊髓型颈椎病伴髓内高信号明亮清晰境界清楚的患者术后改善率较低,手术效果较差。结论脊髓型颈椎病患者的预后与患者的年龄、病程、脊髓受压比例及髓内高信号等多种因素相关,MRI-T2WI髓内高信号对患者的手术预后有指导意义。

Objective To explore the relation between the clinical prognosis of patients with cervical spondylosis myelopathy and the intramedullary high signal on T2WI MRI.Methods There were 57 cases of patients who were diagnosed as cervical spondylosis myelopathy from July 2009 to July 2011.The patients were divided into 3 groups according the different type of intramedullary high signal on T2WI MRI in the research.The three groups were classified as no intramedullary high signal on T2WI MRI,faint and fuzzy border intramedullary high signal on T2WI MRI and intense and well-defined border intramedullary high signal on T2WI MRI.The patients′ age,the duration of the disease,the preoperative JOA,the compression ratio of spine cord,the postoperative JOA and the recovery rates at the final follow-up were compared.Results There were 34（59.65%） patients with intramedullary high signal,18 patients with faint and fuzzy border signal,16 patients with intense and well-defined border signal.Patients with cervical spondylosis myelopathy who didn′t have the intramedullary high signal or had faint and fuzzy border signal had a better recovery rates and clinical effects,however those who had intense and well-defined border signal had a worse recovery rates and clinical effects.Conclusion The clinical prognosis of patients with cervical spondylosis myelopathy is related to the patients′ age,the duration of the disease,the compression ratio of spinal cord,the intramedullary high signal and some other factors.The intramedullary high signal on T2WI MRI had a significance to estimate the clinical effects.