新的MRI分级标准对评估退行性颈椎椎管狭窄的临床意义

The New MRI classification standard for evaluation of the clinical significance of the degenerative cervical spinal canal stenosis

目的DCSS（degenerative cervical spinal stenosis，DCSS）新的MRI分级标准与临床症状体征相关性的研究。方法两位MRI医师分析经l临床和影像学检查确诊的100例DCSS患者的MRI表现，应用Kang提出的分级标准，测量C2／3，C3／4，C4／5，c5／6，C6／7平面椎管狭窄程度及分级，并研究患者临床症状体征做一个相关性分析。结果两位医师在对DCSS新的分级标准的应用上组间一致性很好（k=0．955），同时新的分级标准与临床症状也有很好的相关性，0级患者一般无明显阳性体征，2～3级患者中，几乎都表现出阳性神经系统表现，1级患者则必须与临床密切结合。结论新的MRI分级标准对评估颈椎椎管狭窄对临床诊断有很好的指导意义，随着分级的不断提高，患者的体征也愈发明显。

Objective To study the new MRI classification standard of DCSS and the correlation with clinical symptoms and signs. Methods Two MRI doctors analyzed the MRI manifestation of 100 patients with DCSS, which were confirmed by both clinical and radiographic examination, by measuring the plane degrees of stenosis at the level of C2/3, C3/4, C4/ 5, C5/6, and C6/7 on MRI using the classification standard delivered by Kang, and comparing their clinical symptoms and signs. Further correlation analysis was done. Results The interobserver agreement in the grading of spinal stenosis between the two doctors was good （k = 0. 955）. The new classification standard also had good correlation with clinical symptoms. Patients with Grade 0 generally had no positive signs, patients with grade 2 or grade 3 almost all showed posi- tive expression of nervous system, patients with gradel should be closely combined with clinical information. Conclusion The new MRI classification standard of the cervical spinal canal stenosis is good for guiding clinical diagnosis. With the im- provement of the classification, the patient＇s symptoms and signs are also increased obviously.