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目的 :评价磁共振扩散张量成像技术(diffusion tensor imaging,DTI)对脊髓型颈椎病的诊断价值。方法 :对收集的2014年1月至2015年4月20例健康志愿者和50例脊髓型颈椎病(CSM)患者行颈髓DTI。以健康志愿者作为对照组。依据颈髓MRI平扫结果将CSM患者分A、B、C组,A组17例(单纯硬膜囊受压),B组23例(颈髓受压,信号正常),C组10例(颈髓受压,T2高信号)。分析4组颈髓的平均表观扩散系数(ADC)、平均分数各向异性值(FA)之间的差异,对所有受检者行颈髓纤维束成像。结果:对照组C_2/C_3、C_3/C_4、C_4/C_5、C_5/C_6、C_6/C_7之间ADC值及FA值差异无统计学意义(P>0.05),平均ADC值为(0.875±0.096)×10~(-3)mm~2/s,平均FA值为0.720±0.051;对照组与A组比较,平均ADC值、FA值差异无统计学意义,对照组与B、C组及A、B、C组间比较,平均ADC值、FA值差异均有统计学意义。结论:颈髓DTI较常规MRI能够早期、准确地量化脊髓型颈椎病的颈髓微结构改变,颈髓纤维束成像可以反映脊髓纤维束受压损伤的范围。
Objective: To evaluate the diagnostic value of diffusion tensor imaging (DTI) in patients with cervical spondylotic myelopathy. Methods: The cervical spinal cord DTI was collected from 20 healthy volunteers and 50 patients with CSM from January 2014 to April 2015. Healthy volunteers as a control group. CSM patients were divided into groups A, B and C according to the results of cervical cord MRI scan, 17 cases in group A (compression of dural sac only), 23 cases in group B (cervical spinal cord compression and normal signal), 10 cases in group C Cervical compression, T2 high signal). The differences of mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) between the four groups of cervical spinal cord were analyzed. All the subjects underwent cervical spinal cord imaging. Results: There was no significant difference in ADC value and FA between C_2 / C_3, C_3 / C_4, C_4 / C_5, C_5 / C_6 and C_6 / C_7 in the control group (P> 0.05) The average FA value was 0.720 ± 0.051. There was no significant difference in average ADC value and FA value between the control group and the A group. There was no significant difference between the control group and the B and C groups and A, B, C group comparison, the average ADC value, FA value differences were statistically significant. Conclusion: Compared with conventional MRI, cervical spinal DTI can quantify cervical micro-structure changes of cervical spondylotic myelopathy early and accurately. Cervical fiber bundle imaging can reflect the range of spinal cord fiber compression injury.