探讨CT及MRI成像对颈椎后纵韧带骨化的诊断及评估价值

目的 探讨MRI及CT成像对颈椎后纵韧带骨化的诊断及评估价值.方法 随机选取2013年4月至2015年7月本院收治的颈椎后纵韧带手术患者76例,根据术前CT成像特点将其分为不规则型、块状型、山丘型和蕈伞型.其中山丘型和蕈伞型患者行前路手术,不规则型和块状型患者视其病情行后路或前路手术.术后采用JOA评分法对患者脊髓功能进行评估,并采用MRI T2加权图像分类法对患者进行手术预后评估.结果 不规则型组脊髓功能改善率为(56.1±16.9)％,块状型组为(58.8±9.5)％,山丘型组为(61.6± 13.8)％,蕈伞型组为(63.9±10.7)％,CT成像各组患者术后脊髓功能改善率相比差异无统计学意义(P＞0.05);在MRI成像各组患者中三角型组改善率最低(50.1±7.3％),水滴型组最高(65.9±14.4％),差异具有统计学意义(P＜0.05).结论 CT能够为临床提供颈椎骨化后纵韧带的精确图像,对于制定手术方案及精确实施手术具有十分积极的意义,但在患者术后评估方面,MRI成像对于脊髓功能的反映更为清晰.

Value of CT and MRI imaging in diagnosis and assessment of cervical ossification of posterior longitudinal ligament

Objective To explore the value of CT and MRI imaging in the diagnosis and assessment of cervical ossification of posterior longitudinal ligament.Methods 76 patients with cervical ossification of posterior longitudinal ligament admitted into our hospital from April,2013 to July,2015 were randomly selected.Before operation,the patients were divide into irregular,flat,hilly,and fungating types according to the imaging features of CT.The patients of hilly and fungating types were given anterior approch operation;and the patients of flat and irregular types were given posterior or anterior approch operation according to the patients' conditions.After operation,the spinal function was evaluated with JOA scoring;and the evaluation of the patients' postoperative prognosis was carried out with MRI T2 weighted image classification methods.Results The improvement rate of spinal function was (56.l± 16.9)％ in the irregular group,(58.8±9.5)％ in the flat group,(61.6± 13.8)％ in the hilly group,and (63.9±10.7)％ in the fungating group,with no statistical differences between the CT-typed groups (P＞0.05).In the MRI-typed groups,the improvement rate of the triangular type was the lowest[(50.1±7.3)％] and that of the teardrop-shaped type was the highest[(65.9±14.4)％],with a statistical difference (P＜0.05).Conclusions CT can provide exact image of longitudinal ligament after the ossification of cervical vertebra;it has very positive significance in the operation plan-making and the exact implementation of the operation;but in the postoperative evaluation of the patients,MRI imaging reflects the spinal function more distincter.