Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Eur Spine J. 2019 Aug;28(8):1872-1878. doi: 10.1007/s00586-019-06013-1. Epub 2019 May 20.
To explore the changes in diffusion tensor imaging (DTI) parameters in cervical spinal cord in Hirayama disease (HD) patients and healthy volunteers and to compare these parameters between cervical flexion and neutral positions in HD patients.
Seventeen male patients with HD and eleven healthy young males were included to receive DTI scans in cervical flexion and neutral positions. The FA and ADC values of different levels were measured based on the region of interest drawn on the mid-sagittal plane. The dynamic compressed level's parameters were defined as the lowest and the second lowest FA and the highest and the second highest ADC, respectively. The clinical assessment of patients was obtained using their disabilities of the arm, shoulder and hand (DASH) scores.
For the HD patients, the FA values in the cervical flexion position were lower and the ADC values were much higher than those in the cervical neutral position. Compared with the controls, the ADC values were significantly higher in the lower levels (C5/6-C7/T1) and the FA values obviously lower at C7/T1 in HD patients in cervical neutral position. The FA and ADC values of the dynamic compressed level in HD patients deviated significantly from the average of the lower levels in controls. Both the FA and ADC values of the dynamic compressed level correlated with the DASH scores (FA, R = 0.520, P = 0.001; ADC, R = 0.421, P = 0.005).
DTI parameters can support a hypothesis of dynamic cervical flexion compression and noninvasively reveal the neural status of HD patients. These slides can be retrieved under Electronic Supplementary Material.
探讨平山病（HD）患者颈椎脊髓弥散张量成像（DTI）参数的变化，并比较 HD 患者颈椎前屈位与中立位的DTI 参数。
纳入 17 名男性 HD 患者和 11 名健康年轻男性，分别在颈椎前屈位和中立位进行 DTI 扫描。在正中矢状面绘制感兴趣区，测量不同节段的 FA 和 ADC 值。将动态受压节段的参数定义为最低和第二低的 FA 值以及最高和第二高的 ADC 值。通过患者的臂肩手残疾（DASH）评分评估其临床状况。
HD 患者颈椎前屈位的 FA 值较低，ADC 值明显高于中立位。与对照组相比，HD 患者中立位下下颈段（C5/6-C7/T1）的 ADC 值明显升高，C7/T1 段的 FA 值明显降低。HD 患者动态受压节段的 FA 和 ADC 值明显偏离对照组下颈段的平均值。HD 患者动态受压节段的 FA 和 ADC 值与 DASH 评分均相关（FA，R = 0.520，P = 0.001；ADC，R = 0.421，P = 0.005）。
DTI 参数可以支持颈椎前屈动态压迫假说，并无创性揭示 HD 患者的神经状态。这些幻灯片可以在电子补充材料中检索到。
