扩散张量成像对颈椎病脊髓早期损伤的研究

Research the Value of Diffusion Tensor Imaging in Cervical Spinal Cord Earlier Injury

目的:探讨磁共振(MR)扩散张量成像(DTI)作为定量分析方法,对脊髓型颈椎病(CSM)脊髓早期损伤诊断的应用价值。方法:选择45例经临床及影像诊断为脊髓型颈椎病患者,颈椎常规MRI检查显示脊髓内无异常信号,使用单次激发自旋回波平面(SE-EPI)序列,进行DTI扫描。测量压迫部位脊髓的ADC值及FA值作为病例组,选择病变上或下方两个节段以上未受压正常脊髓作为正常对照组,测量其ADC值及FA值。分析病例组与对照组间ADC及FA值差别,计算ADC值及FA值诊断脊髓损伤的敏感性。结果:所有脊髓型颈椎病患者经DTI检查均可得到ADC图及FA图,经图像后处理,脊髓显示清晰,图像无变形及伪影。3例脊髓型颈椎病患者ADC值降低,42例脊髓型颈椎病患者ADC值增高,平均ADC值为(1.388±0.149)×10-3 mm2/s。44名脊髓型颈椎病患者FA值降低,1名脊髓型颈椎病患者FA值增高,平均FA值为0.476±0.085,受压处脊髓平均ADC值升高,平均FA值下降,与正常值比较差别有统计学意义。ADC值诊断的敏感性为93.33%,FA值诊断的敏感性为97.78%。结论:DTI与常规MR比较,能早期而准确地诊断脊髓型颈椎病脊髓早期损伤。

Objective：To investigate the magnetic resonance diffusion tensor imaging（DTI） in the diagnosis of cervical spondylotic myelopathy（CSM）,which was a quantitative analysis method.Method：Clinical and imaging diagnosed 45 patients who have cervical spondylosis enter this experiment.Conventional cervical MRI revealed no abnormal signal in the spinal cord.These 45 cases were examined with routine MRI and DTI on MR scanner using single shot echo planar imaging（SE-EPI） sequences.ADC and FA values of the parts of spinal cord compression were measured.Selected lesions above or below the two segments in the normal Spinal cord as a normal control group,Analysis the differences in ADC and FA values between cases and control groups,then calculate the sensitivity of the ADC and FA values in the diagnosis of spinal cord injury.Results：All cervical spondylosis cases completed the examinations without obvious artifacts on the diflusion tensor images.Three cases had decreased ADC values,forty-two patients had increased ADC values,the mean ADC value were（1.388±0.149）×10-3 mm2/s,forty-four patients had decreased FA values,one patient with FA values increased,the average FA value were 0.476±0.085.The mean ADC value of compression at the cervical spinal cord increases,the average FA value decreased,there were significant differences compared with normal group.The diagnostic sensitivity of ADC and FA values are 93.33 %,97.78 %.Conclusion：Compared with conventional MR,DTI can accurately diagnose the cervical spondylotic myelopathy of cervical spinal cord earlier injury.