颈椎单开门扩大成形术后脊髓信号强度变化作用的临床观察

目的探讨颈脊髓压迫性病变中MRI髓内信号强度的改变与临床症状及疾病预后的关系。方法对选取的46例颈脊髓压迫性病变的病人进行多因素分析。结果术前正常信号/正常信号(N/N)组有13例,正常信号/高信号(N/Hi)组有26例,纯信号/高信号(Lo/Hi)组有7例。随访时Lo/Hi组恢复率明显低于其他两组,术前脊髓最大受压处的横截面积在N/N组、N/Hi与Lo/Hi组之间差异显著,术后JOA评分3组之间也有差异。结论脊髓受压后出现的髓内信号强度的改变,多表现为T2加权序列高信号,单独出现预示脊髓有一定的修复功能,但如同时出现T1加权序列改变则预后不良。

The Clinic Observation on Intramedullary Signal Density Change after Cervical Laminoplasty

Objective To probe whether the change of intramedullary signal intensity(SI)on T2-weighted MR images in cervical compressive myelopathy are related to the clinical factors and the prognosis. Methods There were 46 patients in this study,MR imaging was performed before operation and at 6 months after operation. According to SI changes on MR,patients are divided 3 groups:group N/N;group N/Hi and group Lo/Hi. The multiple survey factors are analysed using the Multiple comparison test and Mann-Whitney test. Results There were 13 group N/N,26 group N/Hi,7 group Lo/Hi cases before surgery. Statistical analyses of postoperative recovery showed striking significant difference between Lo/Hi and other two group. Statistical analyses showed significant difference in transverse area of the spinal cord at maximum. Conclusion The change of SI in compressed spinal cord often dispalyed high SI on T2-weighted,and to some extent showed recuperative potential,but it showed unfavourable prognosis to follow T1-weighted sequence change.