MRI检查对颈椎病患者椎间盘及颈髓病变检出率的影响

Influence of MRI on the detection rate of cervical disc and spinal cord lesions in patients with cervical spondylosis

目的研究磁共振成像(magnetic resonace imaging,MRI)检查颈椎病患者椎间盘及颈髓病变的检出率。方法选取2017年3月-2019年3月我院颈椎病患者216例,均行MRI检查、CT检查。比较MRI检查、CT检查颈椎病的检出率、颈椎病影像征象的检出率及神经根型、脊髓型颈椎病的检出率。结果MRI检查颈椎病患者椎间盘膨出及突出、椎间盘变性、椎间盘纤维环病变、颈髓缺血性损伤、后纵韧带病变、颈椎病椎间隙狭窄、钩突增生、椎体后缘骨赘、小关节突增生、骨性椎管狭窄、颈椎曲度异常检出率均高于CT检查(P<0.05);MRI检查、CT检查颈椎病患者椎间孔狭窄、椎管狭窄检出率比较,差异无统计学意义(P>0.05);MRI检查椎间盘钙化、椎小关节骨质增生、椎间盘积气检出率低于CT检查,椎间盘突出、黄韧带增厚、脊髓变性、硬膜囊受压、神经根受压检出率高于CT检查(P<0.05);MRI检查神经根型颈椎病检出率94.44%、脊髓型颈椎病检出率88.89%高于CT检查检出率75.00%、25.25%(P<0.05)。结论MRI检查颈椎病患者能提高椎间盘及颈髓病变的检出率,对多种颈椎病变征象显著,有助于颈椎病分型的鉴别诊断,从而为临床治疗方案的制定提供科学依据。

Objective To study the detection rate of cervical disc and spinal cord lesions in patients with cervical spondylosis by magnetic resonance imaging(MRI).Methods A total of 216 patients with cervical spondylosis in our hospital from March 2017 to March 2019 were selected,all of them underwent MRI and computed tomography(CT)examination.The detection rate of cervical spondylosis,imaging signs of cervical spondylosis,and cervical spondylosis of nerve root type and spinal cord type by MRI and CT were compared.Results The detection rates of cervical spondylosis patients with disc herniation and protrusion,disc degeneration,disc annulus fibrosus disease,cervical spinal cord ischemic injury,posterior longitudinal ligament disease,cervical intervertebral space stenosis,uncinate process hyperplasia,vertebral posterior margin osteophyte,facet hyperplasia,bony spinal stenosis,abnormal cervical curvature by MRI examination were higher than that by CT examination(P<0.05).There were no significant differences in the detection rates of foramen stenosis and spinal canal stenosis between MRI and CT examination(P>0.05);the detection rates of intervertebral disc calcification,vertebral facet joint hyperosteogeny and intervertebral disc pneumatosis by MRI examination were lower than that by CT examination;the detections rates of intervertebral disc herniation,ligamentum flavum thickening,spinal degeneration,dural sac compression and nerve root compression by MRI examination were higher than that by CT examination(P<0.05);the detection rates of cervical spondylotic radiculopathy and cervical spondylotic myelopathy by MRI examination were 94.44%and 88.89%,which were higher than 75.00%and 25.25%of the detection rates by CT examination(P<0.05).Conclusion MRI examination of patients with cervical spondylosis can improve the detection rates of intervertebral disc and cervical spinal cord lesions,and has significant signs for a variety of cervical lesions,which is helpful for the differential diagnosis of cervical spondylosis classification,so as to provide scientific basis for the formulation of clinical treatment plan.