脊髓型颈椎病高场强磁共振成像探讨

目的 研究脊髓型颈椎病(CSM)的MRI成像特点及其临床意义。方法 分析主诉有颈肩痛或／和肢体麻木、乏力就诊者134例，经诊断CSM者80例，并根据临床表现分组比较MRI表现。结果 非CSM者MRI表现出椎间盘变性或轻度突出、骨赘形成但不构成对脊髓压迫；CSM病例表现不同程度椎间盘突出、椎体后缘骨赘形成及硬膜囊和脊髓受压，其中69例(86．25％，)脊髓受压，11例(13．75％)脊髓受压变性。临床症状严重者，MRI表现出颈髓变性显著增多，术后脊髓变性信号仍存在。结论 高场强MRI可良好显示CSM中椎间盘退变突出、骨赘形成及脊髓受压变性，为临床诊断与外科治疗提供依据。

Clinical evaluation of the enhanced MRI characteristics in cervical spondylotic myelopathy

Objective To evaluate the MRI characteristics in cervical spondylotic myelopathy (CSM) and its clinical significance. Methods CSM was confirmed in 80 patients out of 134 patients suffering from pains in the neck and shoulder or/and extremity numbness by both MRI and clinical examinations. MRI appearances in different groups divided according to different clinical manifestations were compared. Results MRI in non-CSM group showed disc degeneration or mild disc herniation and formation of osteophyma without compression of the spinal cord. MRI in CSM group, however, showed different degrees of disc herniation and formation of osteophyma with membranous sac and spinal cord compression. Spinal cord compression and spinal cord denaturalization were found in 69 cases (86.25%) and 11 cases (13.75%), respectively. MRI showed spinal cord denaturalization in those with severe symptoms and the abnormal signal in spinal cord also existed after operation. Conclusion Enhanced MRI can provide good image of disk degeneration, disc herniation, formation of osteophyma, and compressed spinal cord even with denaturalization, and can also be helpful for clinical diagnosis and surgery.