平山病的影像学研究进展

The imageological advances in Hirayama disease

平山病(Hirayama disease)是以单侧上肢远端肌萎缩起病为特点的一种良性自限性疾病。早期因诊断技术限制及临床认识不足导致误诊率较高。近年来由于肌电图和影像学检查手段发展,临床病例增多,平山病逐渐为人熟知。X线、CT可以清晰显示患者颈椎曲度、局部节段稳定性及椎间小关节退变程度、后纵韧带是否骨化,而中立位颈椎MRI示失连接现象及屈颈位MRI发现硬膜前移则是最重要的影像学征象。本文将对平山病的临床表现和肌电图特点作一简要介绍,并对其影像学诊断技术及征象进行详细综述。

Hirayama disease is benign and self-limited, characterized by atrophy of unilateral upper extremity. Misdiagnosis was common due to the restriction of diagnostic techniques in the past. In recent years, Hirayama disease is familiar to us because of the rapid development of electromyography and imageological examinations. X-ray and CT scan play an important role in evaluations on cervical curvature, segmental stability, degeneration of facet joints and posterior longitudinal ligament. Loss of attachment in neutral cervical MRI and anterior shift of dura mater in flexion cervical MRI are the most important signs. This review summarizes the imageological examinations and characteristic signs of Hirayama disease in detail, together with a brief introduction to clinical manifestations and electromyography features.