CT与MRI对脊髓型颈椎病和神经根型颈椎病的诊断价值分析

Diagnostic Value of CT and MRI for Cervical Spondylotic Myelopathy and Cervical Spondylotic Radiculopathy

目的评价CT与MRI在脊髓型颈椎病和神经根型颈椎病诊断中的价值。方法回顾性分析术前经CT和MRI初诊并术后病理证实为脊髓型颈椎病和神经根型颈椎病的CT和MRI资料各150例,并以病理结果为金标准,评估CT与MRI对脊髓型颈椎病和神经根型颈椎病术前诊断准确率,同时比较两种检查对颈椎病各种影像征象的诊断价值。结果 CT和MRI对于神经根型颈椎病的术前诊断准确率无明显差异(P>0.05),MRI对于颈髓型颈椎病的术前诊断准确率显著高于CT,CT对椎小关节骨质增生、椎间盘钙化、椎间盘积气征象的诊断效能较MRI高,而MRI对于椎间盘突出、黄韧带增厚、硬膜囊受压、脊髓变性、神经根受压征象的诊断效能较CT高。两者检查方法对于椎间孔狭窄及椎管狭窄征象的诊断效能,在统计学上无明显差异(P>0.05)。结论 CT和MRI对于神经根型颈椎病的术前诊断准确率均较高,对于脊髓型颈椎病的术前诊断准确率MRI占有绝对的优势,CT联合MRI检查可以提高脊髓型颈椎病的术前诊断准确率。

Objective To evaluate the value of CT and MRI in the diagnosis of cervical spondylotic myelopathy and cervical spondylotic radiculopathy.Methods Retrospective analysis of 150 cases of CT and MRI data of cervical spondylotic myelopathy and cervical spondylotic myelopathy confirmed by CT and MRI at the initial diagnosis and postoperative pathology.The pathological results were used as the gold standard to evaluate the accuracy of preoperative diagnosis of cervical spondylotic myelopathy and cervical spondylotic radiculopathy by CT and MRI.The diagnostic value of the two examinations for various imaging signs of cervical spondylosis was compared.Results CT and MRI had no significant difference in the accuracy of preoperative diagnosis of cervical spondylotic radiculopathy(P>0.05).The accuracy of MRI for preoperative diagnosis of cervical spondylotic myelopathy was significantly higher than that of CT.The diagnostic efficiency of CT for vertebral facet joint hyperplasia,intervertebral disc calcification and intervertebral disc gas accumulation is higher than that of MRI,while MRI is more important for disc herniation and ligamentum flavum.The diagnostic efficacy of thick and dural sac compression,spinal cord degeneration,and nerve root compression is higher than CT.There was no statistically significant difference in the diagnostic efficacy of the two methods for the diagnosis of intervertebral foramen stenosis and spinal stenosis(P>0.05).Conclusion CT and MRI have higher accuracy in preoperative diagnosis of cervical spondylotic radiculopathy.MRI has an absolute advantage in preoperative diagnosis accuracy of cervical spondylotic myelopathy.CT combined with MRI can improve the accuracy of preoperative diagnosis of cervical spondylotic myelopathy.