Roth C, Papanagiotou P, Krick C, Reith W, Grunwald I Q
Abteilung Neuroradiologie, Universitätsklinikum des Saarlandes, 66426 Homburg.
Radiologe. 2006 Nov;46(11):993-1000. doi: 10.1007/s00117-005-1251-9.
This article gives an overview of the diagnostic possibilities available in the diagnosis of cervical myelo- and radiculopathy. We compared conventional myelography, CTM, and MRI.
Twenty-five patients with clinical evidence of cervical myelo- or radiculopathy were included. Sagittal and transverse T1-weighted (T1w) TSE and T2-weighted (T2w) TSE sequences were compared with myelography and CTM. Statistical analysis was performed using Wilcoxon's -test.
Disc herniation could be depicted in CTM as well as in MRI. The extent of herniation did not differ between CTM and T1w. The extent of herniation seemed higher on T2w than on T1w (p <0.001). Foraminal encroachment was easier to diagnose in CTM. When regarding transverse T1w and T2w images simultaneously, a missing root in MRI corresponded to a missing root in CTM and conventional myelography and vice versa. Our data demonstrated the relative inability of MRI to determine whether the compression is by soft tissue or bony structures.
The present study proposes that MRI, when available, should be the imaging method of first choice in patients with suspected radiculo- and myelopathy.
本文概述了颈椎脊髓病和神经根病诊断中可用的诊断方法。我们比较了传统脊髓造影、CTM和MRI。
纳入25例有颈椎脊髓病或神经根病临床证据的患者。将矢状位和横断位T1加权（T1w）快速自旋回波（TSE）序列以及T2加权（T2w）TSE序列与脊髓造影和CTM进行比较。采用Wilcoxon秩和检验进行统计学分析。
CTM和MRI均可显示椎间盘突出。CTM和T1w之间突出程度无差异。T2w上的突出程度似乎高于T1w（p<0.001）。CTM更容易诊断椎间孔受压情况。同时观察横断位T1w和T2w图像时，MRI中神经根缺失对应于CTM和传统脊髓造影中神经根缺失，反之亦然。我们的数据表明MRI相对无法确定压迫是由软组织还是骨结构引起的。
本研究提出，在疑似神经根病和脊髓病的患者中，如有条件，MRI应作为首选的成像方法。
