[磁共振T2加权像高信号位置与脊髓型颈椎病预后的相关性]

[Correlation between magnetic resonance T2-weighted increased signal intensity position and prognosis of cervical spondylotic myelopathy].

作者信息

Li Ling, Yang Zhi-Gao, Shen Hong-Xing, Hou Tie-Sheng

机构信息

Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Aug 18;89(31):2168-70.

PMID:20058591

Abstract

OBJECTIVE

To investigate the correlation between position of the spinal cord with increased signal intensity (ISI) on magnetic resonance images (MRI) and the outcome of surgical treatment for cervical spondylotic myelopathy (CSM).

METHODS

Seventy-two patients with CSM who underwent preoperative MRI were selected. Pre- and post-operative clinical status was evaluated by modified Japanese Orthopedic Association (JOA) score. ISI was evaluated according to the T2-weighted sequences. The JOA score and the recovery ratios among patients with ISI in gray matter (group A), in both gray and white matter (group B) and ISI-negative group were compared.

RESULTS

Forty patients were in ISI-negative group. ISI presenting only in gray matter included 21 cases (group A) and 11 cases were in both gray and white matter group (group B). Preoperative JOA score of ISI positive and negative group had significant difference, but the recovery ratios had no significant difference [recovery ratios of two groups at week 1, week 14, and week 52 were (20.8 +/- 14.5)%, (51.1 +/- 15.6)%, (60.1 +/- 14.2)% and (20.3 +/- 14.3)%, (54.4 +/- 22.3)% and (61.2 +/- 22.3)% respectively; P > 0.05]. The recovery ratios of negative group and group A in week 104 were superior to group B [recovery ratios of negative group, group A, and group B in week 52 were (61.2 +/- 22.3)%, (64.3 +/- 13.3)% and (50.1 +/- 11.2)% respectively; P < 0.05].

CONCLUSION

Patients with ISI in the gray matter alone on T2-weighted MR images have no significantly different surgical outcomes as compared with those without ISI. Patients with ISI in both gray and white matter have worse surgical outcomes than those without ISI.

摘要

目的

探讨磁共振成像（MRI）上脊髓信号增强（ISI）的位置与脊髓型颈椎病（CSM）手术治疗效果之间的相关性。

方法

选取72例行术前MRI检查的CSM患者。采用改良日本骨科学会（JOA）评分评估术前和术后的临床状况。根据T2加权序列评估ISI。比较灰质有ISI的患者（A组）、灰质和白质均有ISI的患者（B组）以及无ISI组患者的JOA评分和恢复率。

结果

40例患者为无ISI组。仅灰质出现ISI的有21例（A组），灰质和白质均出现ISI的有11例（B组）。ISI阳性组和阴性组术前JOA评分有显著差异，但恢复率无显著差异[两组在第1周、第14周和第52周的恢复率分别为(20.8±14.5)%、(51.1±15.6)%、(60.1±14.2)%和(20.3±14.3)%、(54.4±22.3)%和(61.2±22.3)%；P>0.05]。第104周时，无ISI组和A组的恢复率优于B组[第52周时，无ISI组、A组和B组的恢复率分别为(61.2±22.3)%、(64.3±13.3)%和(50.1±11.2)%；P<0.05]。