Ellingson Benjamin M, Salamon Noriko, Holly Langston T
Department of Radiology, David Geffen UCLA School of Medicine, Los Angeles, USA.
Eur Spine J. 2015 Apr;24 Suppl 2(Suppl 2):197-208. doi: 10.1007/s00586-013-2915-1. Epub 2013 Aug 6.
To outline the pathogenesis of cervical spondylotic myelopathy (CSM), the correlative abnormalities observed on standard magnetic resonance imaging (MRI), the biological implications and current status of diffusion tensor imaging (DTI), and MR spectroscopy (MRS) as clinical tools, and future directions of MR technology in the management of CSM patients.
A systematic review of the pathogenesis and current state-of-the-art in MR imaging technology for CSM was performed.
CSM is caused by progressive, degenerative, vertebral column abnormalities that result in spinal cord damage related to both primary mechanical and secondary biological injuries. The T2 signal change on conventional MRI is most commonly associated with neurological deficits, but tends not to be a sensitive predictor of recovery of function. DTI and MRS show altered microstructure and biochemistry that reflect patient-specific pathogenesis.
Advanced imaging techniques, including DTI and MRS, show higher sensitivity to microstructural and biochemical changes within the cord, and may aid in management of CSM patients.
概述脊髓型颈椎病（CSM）的发病机制、标准磁共振成像（MRI）上观察到的相关异常、扩散张量成像（DTI）和磁共振波谱（MRS）作为临床工具的生物学意义及现状，以及磁共振技术在CSM患者管理中的未来发展方向。
对CSM的发病机制及磁共振成像技术的当前前沿进展进行系统综述。
CSM由进行性、退行性脊柱异常引起，导致与原发性机械性损伤和继发性生物性损伤相关的脊髓损伤。传统MRI上的T2信号改变最常与神经功能缺损相关，但往往不是功能恢复的敏感预测指标。DTI和MRS显示微观结构和生物化学改变，反映患者特异性发病机制。
包括DTI和MRS在内的先进成像技术对脊髓内微观结构和生化改变显示出更高的敏感性，可能有助于CSM患者的管理。
