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动态磁共振成像在神经根型颈椎病中的价值:两例报告

The Value of Dynamic MRI in Cervical Radiculopathy: A Report of Two Cases.

作者信息

Gupta Bhavika, Kramer Dallas, Barrett Caitlin C, Xu Chen, Yu Alexander

机构信息

Neurological Surgery, Allegheny Health Network, Pittsburgh, USA.

Neurosurgery, Drexel College of Medicine, Philadelphia, USA.

出版信息

Cureus. 2025 May 1;17(5):e83321. doi: 10.7759/cureus.83321. eCollection 2025 May.

Abstract

Dynamic imaging is well established for evaluating cervical myelopathy but is less commonly utilized for cervical radiculopathy. Typically, cervical radiculopathy is diagnosed using static imaging modalities such as CT or MRI. However, recent studies have demonstrated that spinal disorders can be dynamic in nature and may not be fully captured with static imaging alone. Dynamic MRI (dMRI), performed with the neck in flexion and extension, can assist both in diagnosis and surgical planning. We report two cases of cervical radiculopathy with persistent symptoms despite normal findings on standard static imaging. A dMRI sequence was performed to better visualize the underlying pathology. Notably, movement-dependent changes in the width of the spinal canal were observed. Both patients subsequently underwent artificial disc arthroplasty and experienced complete resolution of their symptoms. While dMRI is not necessary for all patients with spinal conditions, it may offer significant diagnostic value in those with persistent symptoms and inconclusive static imaging. Additionally, it can help clarify spinal anatomy and enhance the precision of surgical planning.

摘要

动态成像在评估脊髓型颈椎病方面已得到广泛应用,但在神经根型颈椎病中的应用较少。通常,神经根型颈椎病是通过CT或MRI等静态成像方式进行诊断的。然而,最近的研究表明,脊柱疾病本质上可能是动态的,仅靠静态成像可能无法完全捕捉到。在颈部屈伸状态下进行的动态MRI(dMRI),有助于诊断和手术规划。我们报告了两例神经根型颈椎病患者,尽管标准静态成像结果正常,但症状持续存在。进行了dMRI序列检查以更好地观察潜在病变。值得注意的是,观察到椎管宽度存在与运动相关的变化。两名患者随后均接受了人工椎间盘置换术,症状完全缓解。虽然并非所有脊柱疾病患者都需要进行dMRI检查,但对于症状持续且静态成像结果不明确的患者,dMRI可能具有重要的诊断价值。此外,它有助于明确脊柱解剖结构,提高手术规划的精确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62eb/12126252/6751f760324a/cureus-0017-00000083321-i01.jpg

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本文引用的文献

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MRI of the cervical spine with neck extension: is it useful?颈椎磁共振成像(MRI)并颈部伸展:是否有用?
Br J Radiol. 2012 Aug;85(1016):1044-51. doi: 10.1259/bjr/94315429. Epub 2012 Jan 3.

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