Statham P F, Hadley D M, Macpherson P, Johnston R A, Bone I, Teasdale G M
Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK.
J Neurol Neurosurg Psychiatry. 1991 Jun;54(6):484-9. doi: 10.1136/jnnp.54.6.484.
One hundred and two patients with suspected cervical spondylotic myelopathy were prospectively investigated using MRI as the initial imaging technique. The aim was to discover if clinicians could manage patients with MRI alone, or if they would find a second investigation necessary. Eighty two patients were managed using MRI alone, 34 of whom were treated surgically. Twenty patients had a second investigation: a myelogram in 18 and a CT myelogram in two. This was performed in nine patients to exclude structural pathology in the thoracic or lumbar region (which was not examined with MRI), and in 11 to obtain more specific information about the cervical region. Only five of these 20 patients had surgical treatment. The diagnosis changed after the second investigation in four patients, but management was not influenced in any of these. MRI is a satisfactory alternative to myelography for most patients with suspected cervical spondylotic myelopathy.
102例疑似脊髓型颈椎病患者采用MRI作为初始成像技术进行前瞻性研究。目的是确定临床医生能否仅通过MRI来管理患者，或者他们是否会认为有必要进行第二项检查。82例患者仅采用MRI进行管理，其中34例接受了手术治疗。20例患者进行了第二项检查：18例进行了脊髓造影，2例进行了CT脊髓造影。9例进行此项检查是为了排除胸段或腰段的结构病变（MRI未检查该部位），11例是为了获取有关颈椎区域更具体的信息。这20例患者中只有5例接受了手术治疗。4例患者在第二项检查后诊断发生了变化，但对其治疗均未产生影响。对于大多数疑似脊髓型颈椎病的患者，MRI是脊髓造影的一种令人满意的替代方法。
