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[1]蔣雯,韓驍,王晉超,等.常規(guī)序列和彌散張量成像序列MRI在頸椎后路椎管擴(kuò)大成形術(shù) 治療脊髓型頸椎病療效評(píng)價(jià)中的應(yīng)用[J].中醫(yī)正骨,2018,30(02):37-40.
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常規(guī)序列和彌散張量成像序列MRI在頸椎后路椎管擴(kuò)大成形術(shù) 治療脊髓型頸椎病療效評(píng)價(jià)中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年02期
頁(yè)碼:
37-40
欄目:
影像診斷
出版日期:
2018-02-20

文章信息/Info

作者:
蔣雯1韓驍1王晉超1馬曉棟2史曉林3梁博程3劉鐘4宋卿鵬1郭華2于愛(ài)紅1程曉光1
1.北京積水潭醫(yī)院,北京 100035; 2.清華大學(xué)醫(yī)學(xué)院,北京 100084; 3.浙江中醫(yī)藥大學(xué) 附屬第二醫(yī)院,浙江 杭州 310005; 4.浙江中醫(yī)藥大學(xué),浙江 杭州 310053
關(guān)鍵詞:
頸椎病 椎管 減壓術(shù)外科 磁共振成像 彌散張量成像
摘要:
目的:探討常規(guī)序列及彌散張量成像(diffusion tensor imaging,DTI)序列MRI在頸椎后路椎管擴(kuò)大成形術(shù)治療脊髓型頸椎病療效評(píng)價(jià)中的應(yīng)用價(jià)值。方法:脊髓型頸椎病患者59例,均為接受過(guò)頸椎后路椎管擴(kuò)大成形術(shù)治療的患者,手術(shù)至本次檢查時(shí)間12~14個(gè)月。按日本骨科學(xué)會(huì)脊髓型頸椎病評(píng)分計(jì)算患者術(shù)后臨床改善率,根據(jù)改善率將患者分為2組,2組患者均行頸椎常規(guī)序列及DTI序列MRI檢查。分析術(shù)后病變節(jié)段最狹窄層面脊髓MRI表現(xiàn),記錄2組患者T2加權(quán)像高信號(hào)影情況,采集DTI序列各向異性分?jǐn)?shù)(fractional anisotropy,FA)、平均彌散率(mean diffusivity,MD)、軸向彌散率(axial diffusivity,AD)及縱向彌散率(radial diffusivity,RD)參數(shù)圖像,測(cè)量FA、MD、AD及RD參數(shù)值,并分別做兩組間對(duì)比。結(jié)果:59例患者中臨床改善較好29例(改善較好組)、改善較差30例(改善較差組)。2組患者常規(guī)序列MRI檢查均示手術(shù)減壓徹底,但部分患者T2加權(quán)像可見(jiàn)高信號(hào)影,其中改善較好組17例、改善較差組25例; 改善較好組T2加權(quán)像出現(xiàn)高信號(hào)影的比例較改善較差組低(χ2=4.390,P=0.036)。DTI序列上,改善較好組FA信號(hào)強(qiáng)度較改善較差組高,MD、AD及RD信號(hào)強(qiáng)度較改善較差組低。2組患者間MD、RD參數(shù)值比較,差異有統(tǒng)計(jì)學(xué)意義,改善較好組低于改善較差組[(0.86±0.13)×10-3mm2·s-1,(0.93±0.13)×10-3mm2·s-1,t=-2.231,P=0.030;(0.58±0.16)×10-3mm2·s-1,(0.67±0.16)×10-3mm2·s-1,t=﹣2.142,P=0.036]; 2組患者間FA、AD參數(shù)值比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[0.54±0.10,0.49±0.10,t=1.704,P=0.094;(1.42±0.12)×10-3mm2·s-1,(1.47±0.13)×10-3mm2·s-1,t=-1.677,P=0.099]。結(jié)論:脊髓型頸椎病患者行頸椎后路椎管擴(kuò)大成形術(shù)后,盡管手術(shù)減壓徹底,但部分患者的脊髓仍可能存在不同程度的損傷,臨床改善較好者的脊髓損傷發(fā)生率低于改善較差者,且前者脊髓微結(jié)構(gòu)的破壞程度較后者輕。常規(guī)序列和DTI序列MRI檢查有助于頸椎后路椎管擴(kuò)大成形術(shù)治療脊髓型頸椎病的療效評(píng)估。

參考文獻(xiàn)/References:

[1] OHYA J,OSHIMA Y,TAKESHITA K,et al.Patient satisfaction with double-door laminoplasty for cervical compression myelopathy[J].J Orthop Sci,2015,20(1):64-70.
[2] LEBL DR,BONO CM.Update on the diagnosis and management of cervical spondylotic myelopathy[J].J Am Acad Orthop Surg,2015,23(11):648-660.
[3] 蔣協(xié)遠(yuǎn),王大偉.骨科臨床療效評(píng)價(jià)標(biāo)準(zhǔn)[M].北京:人民衛(wèi)生出版社,2005:104.
[4] HIRABAYASHI K,MIYAKAWA J,SATOMI K,et al.Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament[J].Spine(Phila Pa 1976),1981,6(4):354-364.
[5] TAKAHASHI M,SAKAMOTO Y,MIYAWAKI M,et al.Increased Mr signal intensity secondary to chronic cervical cord compression[J].Neuroradiology,1987,29(6):550-556.
[6] KAMEYAMA T,ANDO T,YANAGI T,et al.Neuroimaging and pathology of the spinal cord in compressive cervical myelopathy[J].Rinsho Byori,1995,43(9):886-890.
[7] BASSER PJ,MATTIELLO J,LEBIHAN D.MR diffusion tensor spectroscopy and imaging[J].Biophys J,1994,66(1):259-267.
[8] THURNHER MM,LAW M.Diffusion-weighted imaging, diffusion-tensor imaging,and fiber tractography of the spinal cord[J].Magn Reson Imaging Clin N Am,2009,17(2):225-244.
[9] SASIADEK MJ,SZEWCZYK P,BLADOWSKA J.Application of diffusion tensor imaging(DTI)in pathological changes of the spinal cord[J].Med Sci Monit,2012,18(6):73-79.
[10] WEN CY,CUI JL,LIU HS,et al.Is diffusion anisotropy a biomarker for disease severity and surgical prognosis of cervical spondylotic myelopathy?[J].Radiology,2014,270(1):197-204.
[11] ELLINGSON BM,SALAMON N,GRINSTEAD JW,et al.Diffusion tensor imaging predicts functional impairment in mild-to-moderate cervical spondylotic myelopathy[J].Spine J,2014,14(11):2589-2597.
[12] GAO SJ,YUAN X,JIANG XY,et al.Correlation study of 3T-MR-DTI measurements and clinical symptoms of cervical spondylotic myelopathy[J].Eur J Radiol,2013,82(11):1940-1945.
[13] RAJASEKARAN S,YERRAMSHETTY JS,CHITTODE VS,et al.The assessment of neuronal status in normal and cervical spondylotic myelopathy using diffusion tensor imaging[J].Spine(Phila Pa 1976),2014,39(15):1183-1189.
[14] JONES JG,CEN SY,LEBEL RM,et al.Diffusion tensor imaging correlates with the clinical assessment of disease severity in cervical spondylotic myelopathy and predicts outcome following surgery[J].AJNR Am J Neuroradiol,2013,34(2):471-478.
[15] UDA T,TAKAMI T,TSUYUGUCHI N,et al.Assessment of cervical spondylotic myelopathy using diffusion tensor magnetic resonance imaging parameter at 3.0 tesla[J].Spine(Phila Pa 1976),2013,38(5):407-414.
[16] RAJASEKARAN S,KANNA RM,CHITTODE VS,et al.Efficacy of diffusion tensor imaging indices in assessing postoperative neural recovery in cervical spondylotic myelopathy[J].Spine(Phila Pa 1976),2017,42(1):8-13.
[17] WANG KY,IDOWU O,THOMPSON CB,et al.Tract-Specific diffusion tensor imaging in cervical spondylotic myelopathy before and after decompressive spinal surgery:preliminary results[J].Clin Neuroradiol,2017,27(1):61-69.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國(guó)家自然科學(xué)基金面上項(xiàng)目(81271558); 北京市自然科學(xué)基金面上項(xiàng)目(7132061); 北京市衛(wèi)生系統(tǒng)高層次衛(wèi)生技術(shù)人才培養(yǎng)計(jì)劃項(xiàng)目(2013-3-033,2009-2-03); 北京市科學(xué)技術(shù)委員會(huì)首都臨床特色應(yīng)用研究與成果推廣項(xiàng)目(Z161100000516134) 通訊作者:程曉光 E-mail:[email protected]
更新日期/Last Update: 2018-07-02