脊髓型颈椎病MRI表现与预后的相关性

目的:探讨脊髓型颈椎病的MRI改变与患者预后的相关性.材料和方法:将71例脊髓型颈椎病患者,根据T1WI/T2WI的信号变化分为:等/等、等/高、低/高及信号改变在受压部位以外四组,进行手术前后随访,比较改善率.结果:手术后临床症状均有不同程度的改善,脊髓的受压程度与改善率呈负相关(P<0.01),等/等信号组预后较好,低/高信号组预后较差.结论:MRI检查对脊髓型颈椎病的预后判断具有指导意义.     

脊髓型颈椎病的MRI研究进展

脊髓型颈椎病(CSM)是脊髓功能障碍最常见的原因,通常由颈椎骨关节炎导致的脊髓压缩和脊髓内的一些生物损伤引起。磁共振成像中T2WI信号最常用于反映神经功能障碍;磁共振扩散张量成像(DTI)和磁共振波谱(MRS)能反映病变微观结构及生物化学改变,并具有预测神经功能及应对干预的潜能;而磁共振功能成像(BOLD-fMRI)则可以帮助评估脊髓型颈椎病患者外科减压术后神经功能的恢复情况。     

脊髓型颈椎病MRI表现与临床观察

目的　探讨脊髓型颈椎病MRI表现及其临床意义。方法　对 78例脊髓型颈椎病手术前后MRI检查资料进行分析 ,并与ASIA评分改善率进行比较。结果　手术后临床症状均有不同程度的改善 ,脊髓受压程度及异常信号的形态与改善率呈显著负相关 (Ρ <0 .0 1 ) ,脊髓受压程度≥ 1 / 3 ,不论其信号是否异常 ,均预后较差。结论　MRI检查对脊髓型颈椎病的诊断有确定意义 ,对治疗方法选择及判断预后具有指导意义     

MRI在脊髓型颈椎病中的应用及临床价值

MRI在脊髓型颈椎病中的应用，为该病的诊断和治疗提供了丰富的影像学资料。就MRI相关序列及技术在脊髓型颈椎病的应用和有关髓内信号变化的病理生理及与临床的相关性进行了综述。     

MRI在脊髓型颈椎病中的研究进展

在脊髓型颈椎病(CSM) 的诊断中,常规MRI上脊髓的信号改变与神经功能障碍密切相关,扩散张量成像（DTI）和磁共振波谱（MRS）可以作为寻找神经功能损伤放射学标志物和了解脊髓生理学的工具,而功能MRI（fMRI）有助于评估CSM减压术后神经功能恢复情况。综述常见MRI技术在CSM病人诊断与治疗中的研究进展。     

MRI在脊髓型颈椎病中的应用及临床价值

MRI在脊髓型颈椎病中的应用,为该病的诊断和治疗提供了丰富的影像学资料.就MRI相关序列及技术在脊髓型颈椎病的应用和有关髓内信号变化的病理生理及与临床的相关性进行了综述.     

CT、MRI对脊髓型颈椎病的诊断分析

目的探讨CT、MRI对脊髓型颈椎病（CSM）的诊断价值。方法对32例CSM患者的CT、MRI资料进行回顾性分析。结果 32例患者中,CT显示骨性椎管狭窄5例,其中先天性狭窄3例,椎体缘骨质增生22例,钩突和关节突关节增生20例,有不同程度椎间盘突出23例,后纵韧带及项韧带钙化13例。MRI显示椎间盘突出、变性28例,后纵韧带增厚21例,黄韧带增厚7例,全部病例脊髓不同程度受压,其中脊髓变性6例。结论 CT、MRI是重要的检查CSM的方法,能为临床治疗提供确切依据。     

脊髓型颈椎病的MRI与临床

本文总结了６０例脊髓型颈椎病的ＭＲＩ检查,ＭＲＩ异常主要由变性突变或膨出的椎间盘,增生的骨赘压迫颈髓,基髓不同程度受压变形、移位,部分出现变性、囊变。ＭＲＩ检查不仅能直接显示致压物的来源和性质,而且能全面观察颈髓受累的范围和程度,对本病的诊断、鉴别诊断、治疗方法的选择和预的判断具有重要价值,已成为检查脊髓型颈椎病的首选方法。     

脊髓型颈椎病的MRI诊断价值

脊髓型脊椎病较常见，由于椎间盘变性后，周围骨质，小关节及软组织等产乍一系列病理改变，压迫和刺激颈神经根，脊髓等组织而产乍一系列症状。颈椎病是一种退性行变性疾患，退变先出现在软骨包括椎间盘，椎间小关节和钩椎关节的关节软骨，致使软骨缓冲外力．减少振荡的能力降低，脊椎不稳。此后可相继发生骨关节增生，肥大，韧带肥厚，骨化，脊椎滑动，旋转，曲度异常或椎管狭窄等变化。外伤及劳损可促使病变发展。MRI的应用为本病的诊断治疗提供了可靠的依据。本文就MRI扫描诊断72例脊髓型颈椎病的影像学及诊断价值进行探讨。     

Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters

The aim of this study was to evaluate if subjective symptoms, radiographic and especially MR parameters of cervical spine involvement, can predict neurologic dysfunction in patients with severe rheumatoid arthritis (RA). Sequential radiographs, MR imaging, and neurologic examination were performed yearly in 46 consecutive RA patients with symptoms indicative of cervical spine involvement. Radiographic parameters were erosions of the dens or intervertebral joints, disc-space narrowing, horizontal and vertical atlantoaxial subluxation, subluxations below C2, and the diameter of the spinal canal. The MR features evaluated were presence of dens and atlas erosion, brainstem compression, subarachnoid space encroachment, pannus around the dens, abnormal fat body caudal to the clivus, cervicomedullary angle, and distance of the dens to the line of McRae. Muscle weakness was associated with a tenfold increased risk of neurologic dysfunction. Radiographic parameters were not associated. On MR images atlas erosion and a decreased distance of the dens to the line of McRae showed a fivefold increased risk of neurologic dysfunction. Subarachnoid space encroachment was associated with a 12-fold increased risk. Rheumatoid arthritis patients with muscle weakness and subarachnoid space encroachment of the entire cervical spine have a highly increased risk of developing neurologic dysfunction. Received: 31 December 1999 Revised: 30 May 2000 Accepted: 5 June 2000     

急性颈椎外伤的MRI诊断

目的 分析急性颈椎外伤的MRI征象,评价MRI在急性颈椎外伤诊断中的价值及限度。方法收集急性颈椎外伤150例,均有MRI检查和X线平片,15例有CT片,采用14个参数进行分析记录。结果150例中MRI检出骨折51个,小关节脱位30个,椎体脱位35个;外伤性椎间盘突出40个,硬膜外血肿2例;脊髓损伤69例;脊髓受压迫20例;前、后纵韧带损伤21例;棘间韧带和黄韧带损伤15例;椎前血肿或水肿30例;椎旁和背侧软组织损伤40例;X线平片发现椎体骨折55个,椎体脱位35个;小关节脱位35例,附件骨折25个,椎前软组织肿胀20例。15例CT均发现骨折,小关节脱位,椎管狭窄。结论MRI在显示脊髓、韧带、椎间盘和软组织损伤方面优于CT和X线平片。MRI能全面反映颈椎各种损伤的病理特征,为评估颈椎稳定性提供充分的依据;MRI和X线片的骨折检出率没有明显差异,CT应该用于复杂的颈椎骨折检查。     

颈椎病致椎-基底动脉供血不足的影像表现

目的 依据临床与影像表现,探讨颈椎病致椎-基底动脉供血不足的机制及防治要点。方法 122例颈椎病患者均经磁共振血管成像(MKA)和常规X线检查,部分病例还经CT扫描检查。分析影像表现与临床经过的关系。结果 122例患者中,颈椎动脉MRA显示正常者106例(86.89％),各种异常者共16例(13.19％),其中,先天性发育不良3例,扭曲纤细6例,单侧缺如1例,畸形1例,硬化性改变2例,以及狭窄3例。约85％(103/122)的病例经保守性治疗后,于2周至2个月期间临床症状明显缓解或消失。结论 虽然颈椎骨质增生与横突孔狭窄可导致颈椎病发生。但是,作者认为临床上较多遇到的、更为重要的病因是颈交感神经受到激惹引起椎动脉痉挛进而诱发本病。临床上最关键的防治措施是防止颈椎失稳。     

MRI in the assessment of the supportive soft tissues of the cervical spine in acute trauma in children

We carried out a retrospective analysis of imaging and clinical findings in 52 children with a history of cervical spinal trauma. No patient had evidence of a fracture on plain films or CT. All had MRI at 1.5 T because of persistent or delayed symptoms, unexplained findings of injury or instability, or as further assessment of the extent of soft-tissue injury. Clinical follow-up ranged from 6 months to 3.5 years. MRI was evaluated for its influence on therapy and outcome. MRI was positive in 16 (31 %) of 52 patients. Posterior soft-tissue or ligamentous injury was the most common finding in the 10 patients with mild to moderate trauma, while acute disc bulges and longitudinal ligament disruption, each seen in one case, were uncommon. MRI was superior to CT for assessment of the extent of soft-tissue injury and for identification of spinal cord injuries and intracanalicular hemorrhage in the six patients with more severe trauma. MRI specifically influenced the management of all four patients requiring surgery by extending the level of posterior stabilization. No patients with normal MRI or any of the 10 with radiographically stable soft-tissue injury on MRI, developed delayed clinical or radiographic evidence of instability or deformity. Received: 5 August 1997 Accepted: 13 October 1997     

椎间盘炎的MRI诊断及临床表现

目的探讨椎间盘炎的MRI表现。方法对36例经临床及手术病理证实的椎间盘炎患者行MRI检查,矢状位及轴位FSE序列T1WI、T2WI及STIR序列,其中6例行Gd-DTPA对比增强扫描,分析其MRI表现。结果36例中44个椎间盘炎,其中43个椎间隙变窄,椎间盘不同程度破坏、碎裂,1个椎间隙变化不明显;39个椎间盘T1WI呈低信号,5个呈等信号;41个椎间盘T2WI呈高信号,3个呈低信号;42个椎间盘"髓核征"阳性;44个椎间盘相邻椎体不同程度受累破坏;22个椎间盘炎有椎旁软组织脓肿。6例行Gd-DTPA对比增强扫描显示病变椎间盘、相邻椎体及椎旁软组织明显异常强化。结论椎间盘炎的MRI表现具有特征性,MRI应作为其首选的影像学检查方法。     

Upper thoracic-spine disc degeneration in patients with cervical pain

Objective To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established.Design and patients One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6±14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion.Results Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2–3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7–T1, T1–2, T2–3 and T3–4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patients gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc.Conclusion A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms.This paper was presented at the 9th Scientific Meeting and Exhibition of the International Society for Magnetic Resonance in Medicine and the 18th Annual Meeting and Exhibition of the European Society for Magnetic Resonance in Medicine and Biology, which were held jointly in Glasgow, Scotland, UK, April 2001.     

颈椎动态MRI评估颈椎椎管变化

目的采用颈椎动态MR扫描，观察椎间隙水平硬膜囊前后径（DSD）的变化，了解活动状态下各退变因素对椎管的影响。方法对临床拟诊颈椎管狭窄的35例患者行中立位及不同伸屈角度矢状面T2WI，测量DSD，对测量结果进行统计学分析。结果与中立位相比较，35例患者小角度前屈致DSD减小者8例，大角度前屈致DSD减小者9例，后伸位致DSD减小者28例。其中，后伸位及中立位DSD在C2～3节段分别为（10．1±1．1）mm和（10．8±1．0）mm（t=2970，P〈0.05），在C3～4节段分别为（8．8±1．2）mm和（9．2±1．2）mm（t=4．636，P〈0．05），在C4-5节段分别为（7．8±1．5）mm和（8．1±1．5）mm（t=3．641，P〈0．05），差异具有统计学意义。结论颈椎动态MR检查有利于反映颈椎退变因素所导致的椎管狭窄和脊髓压迫的真实情况，后伸位可作为首选补充检查。     

MRI in cervical disk herniation

Summary Eleven operated herniated disks in 10 patients were evaluated preoperatively with plain films, myelography and magnetic resonance imaging. Plain X-ray was a valuable supplement to MRI for studying the bony changes. Myelography showed 7 of 11 herniated disks while MRI gave correct diagnosis in all. It is concluded that MRI can replace myelography and computerized tomography in the preoperative evaluation of cervical herniated disk. The other examinations may be supplementary in some cases.     

MRI appearance of radiation-induced changes of normal cervical tissues

Irradiation causes specific MRI changes in anatomic morphology and signal intensity. To avoid misinterpretation, it is important to consider the potential radiation changes of normal tissue in MRI. The aim of this study was to describe the detected radiation effects on normal cervical tissues in MRI. Pretreatment and posttreatment MRI of 52 patients with primary neck tumors were evaluated retrospectively. The MR imaging was performed before initiating radiotherapy and at the end of the treatment period. Patients underwent follow-up studies within 24 months after the end of irradiation. Edema was the main radiation-induced effect. It was detected in the epiglottis, larynx, pharynx wall, retro- and parapharyngeal space, salivary glands, muscles, and subcutaneous tissue. In some cases the bone marrow of the mandible showed edema, due to osteonecrosis. We additionally detected fluid accumulation in the mastoid cells. Radiation caused volume reduction of the parotid gland, thickening of the pharynx wall, and fatty degeneration of bone marrow. Magnetic resonance imaging is an excellent method of depicting radiation-induced changes of normal tissue. Especially T2-weighted sequences allow the detection of even slight edema. It is important to be aware of the most common radiation-induced changes in MRI and to take them into account when assessing an examination.     

Magnetic resonance imaging of the cervical spine: frequency of degenerative changes in the intervertebral disc with relation to age

AIM: To ascertain the level at which intervertebral disc degeneration of the cervical spine most commonly occurs in each decade from 20-79 years. MATERIALS AND METHODS: Using computer analysis, we retrospectively assessed the mean signal intensity from each cervical disc from T2-weighted spin-echo images in 60 symptomatic patients (10 per decade from the third to eighth inclusive). RESULTS: Age, disc level and interaction between age and level were highly significant predictors for the magnetic resonance imaging (MRI) mean signal intensity from intervertebral discs (p<0.0001 for all three terms). The MRI signals were generally lower as age increased and also for the higher discs (C2-C3, etc). CONCLUSION: In our study we have shown that in younger patients the higher discs are more frequently affected by degeneration than the lower ones. As age increases, the process of degeneration becomes more generalized with less variability between discs.