平山病颈椎自然位和过屈位低场MRI的表现浅析

目的观察平山病颈椎自然位及过屈位低场磁共振成像（MRI）特点，结合文献复习，从而提高对本病的认识。方法对4例临床确诊平山病患者进行颈椎自然位和过屈位扫描并观察其MRI表现。结果自然位见1例颈椎生理曲度异常，5例下颈段（C4—7水平）脊髓萎缩，过屈位显示4例均可见下颈段（1例达上中胸段）脊髓的硬脊膜后壁向前推移，脊髓背侧硬膜外静脉丛扩张，下颈段脊髓局限受压变扁。结论不同体位的颈椎MRI扫描能显示平山病患者的异常表现，结合自然位和过屈位，有助于平山病的诊断。

Objective Reviewed with literature review, make a comprehensive investing of the cervical MRI with the static position and the flexion-extension position of neck, and helping us to learn further more about mechanism of Hirayama disease. Methods 4 cases of Hirayama diseases have been detected by the cervical MRI in static and flexion-extension positions of neck. Collected the data and analyzed by experienced radiologists. Results In the static position, there is 1 case of abnormal cervical vertebra physiology curvature. 3 cases in inferior cervical spine （C4-7 levels） were with spinal cord atrophy. 4 cases in the flexion position were seen a visible forward displacement related to the lower intervertebral disc （over 1 case is above the thoracolumbar）, a significant extradural vein plexus expansion, and a serious compression of inferior cervical spine. Conclusion MRI in different cervical vertebrae positions can show the abnormal appearance of Hirayama disease. Considered with the static position and the flexion position, it will be helpful for diagnosis of Hirayama disease.