Department of Neurosurgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI 53226, USA.
Spine J. 2011 May;11(5):412-5. doi: 10.1016/j.spinee.2011.04.002.
Anteroposterior width of prevertebral soft tissues (PVSTs) in the cervical spine has long been considered a valuable radiographic measurement for evaluation of occult cervical spine pathology. These measurements, generally obtained from lateral radiographs of the cervical spine, have been used clinically as references for the evaluation of patients with traumatic, neoplastic, or other cervical spine disorders. Magnetic resonance imaging (MRI) offers a subtle delineation of the soft-tissue structures anterior to the vertebral column, with the potential for more accurate and sensitive determination of PVST width. Upright magnetic resonance images permit comparison with and validation of previously reported upright lateral radiographic measurements of PVST width. To our knowledge, evaluation of cervical spine PVST width using upright MRI has not been previously published in the English literature.
The purposes of this study were to validate lateral radiographic measurements of PVST width using upright weight-bearing MRI in healthy subjects and quantify effects of spinal level and gender.
Clinical study in asymptomatic volunteers.
Eleven male and eight female volunteers consented and were enrolled in the study. All volunteers were asymptomatic and had no history of cervical spine injury or degenerative disease. Prevertebral soft-tissue width was measured at each cervical level from C2 to C7 using upright weight-bearing MRI. Statistically significant differences in PVST width based on spinal level and gender were determined using two-factor analysis of variance.
Width magnitudes were significantly dependent on gender (p<.0001) and spinal level (p<.0001). All C3 and C6 measurements were below the traditionally accepted values of 7 and 20 mm, respectively, that would be considered "abnormal." Prevertebral soft-tissue width was greater in men at upper and lower extents of the cervical spine. Prevertebral soft-tissue widths reported in the present study were similar in magnitude and level-by-level trends to measurements of asymptomatic volunteers obtained using lateral radiography.
The present study validated the use of lateral radiography to measure PVST width, presented level-by-level and gender-specific normative data, and provided a weighted statistical analysis of differences between normal volunteers and injured patients.
颈椎椎体前方软组织（PVST）的前后径一直被认为是评估隐匿性颈椎病变的有价值的影像学测量指标。这些测量值通常是从颈椎侧位片上获得的，临床上用于评估创伤性、肿瘤性或其他颈椎疾病患者。磁共振成像（MRI）可以提供脊柱前方软组织的细微轮廓，有可能更准确、更敏感地确定 PVST 宽度。直立 MRI 可与之前报道的直立侧位 X 线片上的 PVST 宽度测量值进行比较和验证。据我们所知，以前在英文文献中尚未发表过使用直立 MRI 评估颈椎 PVST 宽度的研究。
本研究旨在使用直立负重 MRI 验证健康受试者的 PVST 宽度的侧位 X 线片测量值，并量化脊柱水平和性别对其的影响。
无症状志愿者的临床研究。
11 名男性和 8 名女性志愿者同意并参与了这项研究。所有志愿者均无症状，无颈椎损伤或退行性疾病史。使用直立负重 MRI 测量每个颈椎水平（C2 至 C7）的椎体前方软组织宽度。使用双因素方差分析确定基于脊柱水平和性别的 PVST 宽度的统计学显著差异。
宽度值在性别（p<0.0001）和脊柱水平（p<0.0001）方面均有显著差异。所有 C3 和 C6 的测量值均低于分别被认为是“异常”的 7mm 和 20mm 的传统接受值。男性在颈椎的上下段的椎体前方软组织宽度更大。本研究报道的椎体前方软组织宽度在大小和各水平趋势上与使用侧位 X 线片测量的无症状志愿者的测量值相似。
本研究验证了使用侧位 X 线片测量 PVST 宽度的方法，提供了脊柱水平和性别特异性的正常参考值，并对正常志愿者和受伤患者之间的差异进行了加权统计分析。
