MSCT与高频超声结合对项韧带退变与颈椎退变相关性研究

Combined MSCT and ultrasound in studying the correlation of nuchal ligament degeneration and cervical degeneration

目的:研究项韧带退变与颈椎退变的关系。方法:病例组65例,对照组58例,两组均进行中立位MSCT颈部容积扫描,中立位与45°前伸位项韧带高频超声扫描,观察项韧带形态、密度、最小横截面积变化率,将两组观察结果与相关测量数据进行对比分析。结果:病例组项韧带33.85%失去原有三棱状外形,38.46%项韧带索状部扭曲,27.69%项韧带索状部出现钙化。病例组与对照组比较,病例组Ⅰ～Ⅳ段项韧带索状部增粗、膜状部增厚,整体密度增高,两组间差异均有统计学意义(P<0.05)。两组间索状部最小横截面积变化率对比,病理组Ⅰ、Ⅱ、Ⅳ段减小,Ⅲ段增大,两组间差异有统计学意义(P<0.05)。结论:项韧带退变与颈椎退变及颈椎病的发生密切相关,其形态、密度、最小横截面积变化率的异常改变同项韧带钙化一样,也是颈椎退变重要的影像表现,提高对此类影像表现的认知,对颈椎病的影像诊断和临床相关治疗工作有重要的意义。

Objective： To study the relationship between nuchal ligament degeneration and cervical degeneration by com- bined MSCT and ultrasound. Methods： The patient group consisted 65 cases with cervical vertebral diseases, and the control group had 58 healthy individuals. Neutral position MSCT volume scanning were performed in each group. High frequency ul- trasound scanning were performed in neutral position and 45° anterial extension position. The morphology, density, minimum cross section area change rate of nuchal ligament were observed and measured. The results and measurement were compared and analyzed. Results： In the patient group, 33.85% of cases had lost the normal triangular shape of the nuchal ligament, 38.46% of cases had funicular twist of the nuchal ligament, 27.69% had cord like calcification of the ligament. Compared to the control group, there were thickening of the funicular and membranous part of the I -1V segment of the nuchal ligament with increased density in the patient group. There were significant differences between the two groups （P〈0.05）. In the patient group, the mini-cross sectional area change rate of the funicular part of I , 11, IV segment of the nuchal ligament decreased and llI segment increased. There were significant differences between the two groups （P〈0.05）. Conclusion： Degenerative changes of the nuchal ligament has close relationship with degeneration of the cervical vertebrae and diseases. Abnormal changes of the morphology, density minimum corss-sectional changes rate as well as calcification of the nuchal ligament are also degenerative appearances of the cervical vertebrae. Familiar with these imaging features is important to the diagnosis and clinical treatment.