脊髓型颈椎病患者颈椎MRI髓内不同类型信号的变化与临床预后的相关性研究

Compare different types of cervical spondylotic myelopathy intramedullary MRI T2WI high signal on the significance of clinical prognosis

目的探讨脊髓型颈椎病患者颈椎MRI上伴有不同类型髓内信号的改变与临床预后的相关研究。方法回顾性分析2010-06-2013-06我院脊柱外科住院治疗的符合纳入研究标准的51例脊髓型颈椎病患者。分析术前及术后临床和MRI图像资料,对术前及术后平均随访34.7个月脊髓信号改变进行评估,比较术前及术后脊髓高信号不同类型变化情况。采用改良JOA评分及临床改善率(RR)来评价临床预后。结果 T2WI高信号的强度评分变化经统计学分析,临床改善率无统计学意义(P>0.05);单节段高信号与多节段高信号经统计学分析,临床改善率具有统计学意义(P<0.05),多节段高信号的患者较单节段高信号的患者临床预后较差;具有T1WI低信号的患者与T1WI等信号的患者相比,临床改善率具有统计学意义(P<0.05),髓内具有T1WI低信号/T2WI高信号的患者较T1WI等信号/T2WI高信号的患者临床预后差。结论脊髓型颈椎病患者MRI信号强度的改变具有多种类型的变化,其中MRI T2WI高信号发生的节段数不同及是否伴有T1WI低信号能评价患者临床预后。多节段T2WI高信号及T1WI低信号是临床预后差的表现。

Objective To study the cervical spondylotic myelopathy with different types of in- tramedullary MRI signal intensity change and clinical prognosis of correlation. Methods Retrospectively studied 51 cases underwent cervical spine surgery of cervical spondylotic myelopathy cervical and who met the inclusion criteria during June 2010 to June 2013 in our hospital. The clinical and MRI image data of preoperation and postoperation were analyzed. To evaluate spinal signal change of the preoperative and postoperative mean follow-up of 34.7 months, the preoperative and postoperative spinal cord high signal changes of different types were compared. The modified JOA score and clinical period （RR） were used to evaluate the clinical outcome. Results There was no statistical significance in the RRs of patients with different points in the T2WI （P〉0.05）. There was statistical significance in the RRs of patients with different segment high signal （P〈0.05）. Multiple segmental high signal was correlated with a poor clinical period. There was statistical significance in the RRs of patients with T1WI low signal and no T1WI low signal. Patients with T1WI low signal were associated with a poor clinical period （P〈0.05）. T,WI low signal/T2WI high signal was usually the bad sign of clinical prognosis. Conclusion Cervical spondylotic myelopathy MRI signal intensity changes with various types of changes, including MRI T2WI high with several different section of the signal occurred and whether T1WI low signal to evaluate the clinical outcome. Multiple segmental high T2WI signal and T1WI low signal is usually the bad sign of clinical prognosis.