正常颈椎椎间盘及黄韧带的动态MRI初步研究

Kinematic MRI features of the cervical disc and ligamentum flavum in healthy subjects

目的:探讨正常颈椎椎间盘及黄韧带的动态MRI功能变化,为脊髓型颈椎病的研究提供解剖学基础。方法:2015年12月~2016年10月间招募40名健康志愿者,行常规中立位、最大屈曲和后伸位颈椎MRI扫描。观察3种体位颈椎不同节段正中面、左右旁正中面的椎间盘膨出大小并测量黄韧带厚度。比较3种体位不同节段、不同部位的椎间盘膨出及黄韧带厚度的差异。结果:3个不同体位C_(3~7)节段椎间盘有不同程度膨出,随体位变化较小。黄韧带厚度在过伸位>中立位>过屈位,C_(3~4)的左右旁面,C_(4~5)、C_(5~6)的左右旁及正中面,C_(6~7)的右旁及正中面的黄韧带厚度在三种体位间的差异均有统计学意义(P<0.05),进一步两两比较,C_(3~6)左旁、右旁面,C_(4~7)正中面,C_(6~7)右旁面在过屈与过伸位之间,C_(5~6)右旁、正中面在中立位与过伸位之间差异均有统计学意义(P<0.05)。结论:正常颈椎椎间盘在最大屈曲和后伸时变化均较小,黄韧带厚度在不同体位变化较大,以过伸位明显。

Objective： To observe the functional changes of the cervical disc and ligamentum flavum under kinematic magnetic resonance imaging（ MRI）in healthy individuals for anatomic evidence in the diagnosis of cervical spondylotic myelopathy. Methods： Forty healthy volunteers were recruited from December 2015 to October 2016,and undergone kinematic magnetic resonance scanning of the cervical disc by neutral,maximum flexion and posterior extension position,respectively to measure the sizes of cervical disc bugle in the three positions and thickening of ligamentum flavum. Then the difference concerning bugle at each segment and thickening of the ligamentum flavum was compared. Results： Cervical disc bugle to a certain degree was seen from C_（3-7） by the three positions,and the bugle tended to be smaller with changes of the position. The ligamentum flavum thickening varied as maximum extensionneutral maximum flexion,and at different view at each cervical level（ P0.05）,particularly the ligmentum flavum thickening was correlated with C_（3-6） at the left and right side,C_（4-7） at the middle side and C_（6-7） at the right side in the three positions（ P 0.05）. Conclusion： Change of cervical disc bugle size may be slight under the maximum flexion and extension position,yet the ligamentum flavum thickening can be significant in different position,and dominant in the maximum extension position.