Department of Radiology, Peking University Third Hospital, North Huayuan Road No.49, Haidian District, Beijing 100191, China.
Eur J Radiol. 2011 Apr;78(1):82-6. doi: 10.1016/j.ejrad.2010.08.012. Epub 2010 Aug 30.
Cervical flexion movement is supposed to play an important role in the pathogenesis of Hirayama disease. But there is no report on the range of cervical flexed motion in this disease. The purpose of current study was to compare the range of cervical flexed motion in patients with Hirayama disease with the one in healthy controls using conventional lateral flexion radiographs of the cervical spine, and to investigate the diagnostic value of radiographs for Hirayama disease.
This prospective study was approved by a local institutional review board and written informed consent was obtained. From August 2007 to March 2009, conventional flexion cervical radiographs and flexion cervical MRI were performed on 31 Hirayama disease patients (all men, age range, 16-24 years, mean age, 19.52±2.29 years) and 40 control subjects (all men, age range, 16-25 years, mean age, 23.10±2.20 years). The segmental and overall range of cervical flexed motion was quantitatively measured. Receiver operating characteristic curve was calculated and the diagnostic accuracy was qualified by using the area under the curve Az.
Both the segmental and overall range of cervical flexed motion of patients determined by flexion cervical radiographs was greater than that of controls. The Az value was 0.90, indicating a moderate to good ability of conventional flexion radiographs in the diagnosis of Hirayama disease.
Hirayama disease patients have an increased flexed motion range of cervical spine which would contribute to the pathophysiological change and determine its treatment. Conventional flexion radiographs might be suitable to be used as first line radiographic examination, followed by MRI in cases of suspected Hirayama disease.
颈椎前屈运动被认为在平山病的发病机制中起重要作用。但目前尚无平山病患者颈椎前屈运动范围的相关报道。本研究旨在通过颈椎常规侧位屈伸位片比较平山病患者与健康对照组颈椎前屈运动范围，并探讨该影像学检查对平山病的诊断价值。
本前瞻性研究经当地机构审查委员会批准，并获得书面知情同意。2007 年 8 月至 2009 年 3 月，对 31 例平山病患者（均为男性，年龄 16-24 岁，平均年龄 19.52±2.29 岁）和 40 例健康对照者（均为男性，年龄 16-25 岁，平均年龄 23.10±2.20 岁）进行颈椎常规屈伸位片和颈椎 MRI 检查。对颈椎前屈运动的节段和整体范围进行定量测量。绘制受试者工作特征曲线（ROC），并通过曲线下面积 Az 来评估诊断准确性。
颈椎屈伸位片显示，患者的颈椎前屈运动节段和整体范围均大于对照组。Az 值为 0.90，表明颈椎常规屈伸位片对平山病的诊断具有中度至良好的能力。
平山病患者颈椎前屈运动范围增加，这可能导致其病理生理学改变，并决定其治疗方法。常规颈椎屈伸位片可能适合作为平山病的一线影像学检查，在怀疑平山病时，可进一步行 MRI 检查。
