[1]蒋维利,申才良,章仁杰.脊髓型颈椎病病人手术前后MRI T2WI信号改变与临床疗效的关系[J].齐鲁医学杂志,2017,32(06):700-703.[doi:10.13362/j.qlyx.201706020]
 JIANG Weili,SHEN Cailiang,ZHANG Renjie.ASSOCIATION BETWEEN SIGNAL CHANGE ON T2WI AFTER SURGERY AND CLINICAL OUTCOME IN PATIENTS WITH CERVICAL SPONDYLOTIC MYELOPATHY[J].Medical Journal of Qilu,2017,32(06):700-703.[doi:10.13362/j.qlyx.201706020]
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脊髓型颈椎病病人手术前后MRI T2WI信号改变与临床疗效的关系()
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《齐鲁医学杂志》[ISSN:1008-0341/CN:37-1280/R]

卷:
第32卷
期数:
2017年06期
页码:
700-703
栏目:
出版日期:
2018-03-20

文章信息/Info

Title:
ASSOCIATION BETWEEN SIGNAL CHANGE ON T2WI AFTER SURGERY AND CLINICAL OUTCOME IN PATIENTS WITH CERVICAL SPONDYLOTIC MYELOPATHY
文章编号:
1008-0341(2017)06-0700-04
作者:
蒋维利1申才良2章仁杰2
1 蚌埠医学院第二附属医院脊柱外科,安徽 蚌埠 233040; 2 安徽医科大学第一附属医院脊柱病区
Author(s):
JIANG Weili SHEN Cailiang ZHANG Renjie
Department of Orthopaedic Spinal Surgery, The Second Affiliated Hospital of Bengbu Medical College, Bangbu 233040, China
关键词:
脊髓压迫症颈椎病磁共振波谱学
Keywords:
spinal cord compression cervical spondylosis magnetic resonance spectroscopy
分类号:
R681.5;R445.2
DOI:
10.13362/j.qlyx.201706020
文献标志码:
A
摘要:
目的 探讨伴有髓内MRI T2WI高信号的脊髓型颈椎病(CSM)病人高信号改变与临床疗效的关系及其影响因素。
方法 回顾性分析74例伴有颈椎MRI T1WI等信号/T2WI高信号的CSM病人的影像学和临床资料。对74例病人手术前后信号强度进行评分,根据术后MRI T2WI信号的变化,分为高信号强度减弱组(Ⅰ组)、不变组(Ⅱ组)、增强组(Ⅲ组),对3组病人临床及影像学参数测量结果进行统计学分析。
结果 3组间性别、术前脊髓信号评分、术前病变节段脊髓压迫率、术后脊髓压迫率及术前日本骨科协会脊髓功能评分(JOA评分)差异均无显著性(P>0.05);3组术前脊髓信号评分与术前脊髓压迫率、术前JOA评分、术后JOA评分及神经功能改善率均无相关性(P>0.05);Ⅰ组与Ⅱ组及Ⅲ组年龄、病程、高信号发生的节段数目、术前脊髓压迫组织、术后JOA评分及神经功能改善率比较,差异均有显著性(F=3.358~10.354,χ2=9.150、7.113,P<0.05)。
结论 伴有单纯髓内T2WI高信号的CSM病人术后高信号强度减弱提示临床预后良好,但是术前T2WI信号强度评分不能作为临床疗效的评价指标;病人年龄、病程、高信号发生节段情况及脊髓受压迫的组织类型是影响高信号转归的因素。
Abstract:
Objective  To investigate the association between the change in hyperintensity after surgery and clinical outcome in patients with cervical spondylotic myelopathy (CSM) with hyperintensity on T2WI and related influencing factors.
Methods  A retrospective analysis was performed for the imaging findings and clinical data of 74 CSM patients with isointensity on T1WI/hyperintensity on T2WI. The signal intensity score was determined before and after surgery, and according to the signal change on T2WI after surgery, the patients were divided into reduced hyperintensity group (group Ⅰ), no-change group (group Ⅱ), and enhanced signal intensity group (group Ⅲ), and a statistical analysis was performed for clinical and imaging parameters.
Results  There were no significant differences between the three groups in sex, preoperative spinal signal score, preoperative spinal cord compression rate of the segment with lesion, postoperative spinal cord compression rate, and preoperative Japanese Orthopaedic Association (JOA) score (P>0.05). Preoperative spinal signal score was not significantly correlated with the preoperative spinal cord compression rate, preoperative and postoperative JOA scores, and improvement in neurological function (P>0.05). There were significant differences between group Ⅰ and groups Ⅱ/Ⅲ in age, course of disease, number of segments with hyperintensity, type of tissue with spinal cord compression before surgery, postoperative JOA score, and improvement rate of neurological functions (F=3.358-10.354,χ2=9.150 and 7.113,P<0.05).
Conclusion  In CSM patients with simple intramedullary hyperintensity on T2WI, reduced hyperintensity after surgery may indicate good prognosis, but preoperative T2WI signal intensity score cannot be used to evaluate clinical outcome. Age, course of disease, segments with hyperintensity, and type of tissue with spinal cord compression are influencing factors for the outcome of hyperintensity.
更新日期/Last Update: 2018-03-24