Tomsick T A, Peak E, Wang L
From the Department of Radiology, University of Cincinnati Academic Health Center, University Hospital, Cincinnati, Ohio.
AJNR Am J Neuroradiol. 2017 Apr;38(4):840-845. doi: 10.3174/ajnr.A5121. Epub 2017 Mar 9.
Hyperintense fluid-signal anterior median fissure and hyperintense foci resembling the central canal are seen on cervical spine axial T2 MR imaging. They may also be associated with a channel-like T2-hyperintense craniocaudad line on sagittal images. We hypothesized that the hyperintense foci and the sagittal line may represent the base of the anterior median fissure.
In this exploratory study, 358 cervical MR images were analyzed for recording and comparing the incidence/numbers of hyperintense foci, anterior median fissure, and sagittal line as hyperintense foci, anterior median fissure, and sagittal line per patient when present alone or together, both with and without the sagittal line.
Hyperintense foci were identified on 238/358 (66.5%) studies; an anterior median fissure, on 218/358 (60.9%). The hyperintense foci/anterior median fissure ratio was 3.7/2.3 ( = .00001). Anterior median fissures were seen alone less commonly than hyperintense foci were seen alone ( = .045). We identified increased anterior median fissure/patient in a hyperintense foci +anterior median fissure group compared with an anterior median fissure-only group (4.0 versus 3.2, = .05), with similar hyperintense foci/patient in the hyperintense foci+anterior median fissure and hyperintense foci-only groups (5.5 versus 5.8, = .35), and proportional distribution of both across the hyperintense foci+anterior median fissure subgroups (hyperintense foci/anterior median fissure ratio, 1.3). The sagittal line in 89 (24.9%) patients was associated with increased hyperintense foci and anterior median fissure/patient. Greater correlation of anterior median fissure/patient to sagittal line presence was seen in sagittal line subgroup analysis.
This exploratory analysis found an increased anterior median fissure per patient in conjunction with hyperintense foci presence, a proportional increase of both across the hyperintense foci+anterior median fissure group, and greater correlation of anterior median fissure per patient with the sagittal line. These findings suggest that anterior median fissure and hyperintense foci are structurally related, that hyperintense foci may commonly be the base of the anterior median fissure, and that the sagittal line is a manifestation primarily of an anterior median fissure, occasionally appearing as channels that may simulate the central canal.
在颈椎轴位T2加权磁共振成像（MR成像）上可见前正中裂呈高信号液体影，以及类似中央管的高信号灶。在矢状位图像上，它们还可能与一条T2高信号的头尾走行线相关。我们推测这些高信号灶和矢状线可能代表前正中裂的基底。
在这项探索性研究中，对358例颈椎MR图像进行分析，记录并比较高信号灶、前正中裂以及矢状线（当单独或共同出现时）的发生率/数量，同时分析了有无矢状线的情况。
在358例研究中，238例（66.5%）发现了高信号灶；218例（60.9%）发现了前正中裂。高信号灶/前正中裂的比例为3.7/2.3（P = 0.00001）。单独出现前正中裂的情况比单独出现高信号灶的情况少见（P = 0.045）。我们发现，与仅存在前正中裂的组相比，在高信号灶+前正中裂组中每位患者的前正中裂数量增加（4.0比3.2，P = 0.05），在高信号灶+前正中裂组和仅存在高信号灶的组中每位患者的高信号灶数量相似（5.5比5.8，P = 0.35），并且两者在高信号灶+前正中裂亚组中的分布成比例（高信号灶/前正中裂比例为1.3）。89例（24.9%）患者的矢状线与每位患者高信号灶和前正中裂数量的增加相关。在矢状线亚组分析中，观察到每位患者前正中裂与矢状线存在的相关性更强。
这项探索性分析发现，伴有高信号灶时每位患者的前正中裂数量增加，在高信号灶+前正中裂组中两者成比例增加，并且每位患者的前正中裂与矢状线的相关性更强。这些发现表明，前正中裂与高信号灶在结构上相关，高信号灶可能通常是前正中裂的基底，并且矢状线主要是前正中裂的一种表现，偶尔表现为可能类似中央管的通道。
