MRI检查在成人颈椎病临床诊治中的应用价值研究

Application Value of MRI in the Clinical Diagnosis and Treatment of Cervical Spondylosis of Adult

目的研究MRI检查在成人颈椎病临床诊治中的应用价值。方法选取本院2017年2月至2018年3月收治的96例颈椎病患者作为研究对象,比较不同检查对颈椎病的诊断准确率,分析其影像学征象及治疗方法。结果 MRI检查诊断准确率明显高于CT检查(P<0.05);96例患者中CT与MRI检查诊断出颈椎间盘突出有73例,椎管狭窄11例;CT漏诊的11例患者,MRI检查诊断为椎间盘脱出,其中7例伴有脊髓病变,3例寰枢椎半脱位。MRI可见明显“条形囊状”高信号,脊髓受压水肿、变性。73例被CT与MRI检查诊断出颈椎盘突出的患者,其中有41例采用理疗、推拿按摩方式治疗,其余32例采用保守治疗;MRI检查诊断椎间盘脱出的11例伴有脊髓病变的患者需要进行开放式手术治疗,不伴有脊髓病变的采取臭氧联合胶原酶溶盘治疗。结论 MRI和CT检查均可有效显示颈椎间盘突出与椎管狭窄,但MRI检查诊断准确率更高,且能显示脊髓受压、脊髓病变、纤维椎管狭窄与颈椎间盘脱出,能有效指导临床治疗方案的选择与制定。

Objective To study the application value of MRI in the clinical diagnosis and treatment of cervical spondylosis of adult.Methods 96 patients with cervical spondylosis treated in our hospital from February 2017 to March 2018 were selected as research objects.The diagnostic accuracy of different examinations for cervical spondylosis was compared,and the imaging signs and treatment methods were analyzed.Results The diagnostic accuracy of MRI was significantly higher than that of CT(P<0.05).In the 96 patients,73 cases were diagnosed as cervical disc herniation by CT and MRI examinations,and 11 cases were diagnosed as spinal canal stenosis.11 patients misdiagnosed by CT was diagnosed as disc herniation by MRI,of which 7 patients were combined with spinal cord disease and 3 patients were combined with atlantoaxial subluxation.MRI showed obvious"bar-shaped cystic"high signal,and the spinal cord was compressed and then had edema and degeneration.In 73 patients with cervical disc herniation diagnosed by CT and MRI,41 cases were treated with physiotherapy and massage,the remaining 32 were treated with conservative treatment.11 patients with disc herniation and spinal cord disease diagnosed by MRI examination reqired to be treated with open operation.11 patients with disc herniation but without spinal cord disease were treated with ozone combined with collagenase.Conclusion Both MRI and CT examinations can effectively show cervical disc herniation and spinal canal stenosis,but MRI examinations have higher diagnostic accuracy,and can show spinal cord compression,spinal cord disease,fibrous spinal stenosis,and cervical disc extrusion,which can effectively guide the selection and formulation of clinical treatment plans.