磁共振弥散张量成像在无骨折脱位型颈脊髓损伤的临床应用研究

目的 探讨磁共振弥散张量成像(MR-DTI)技术在无骨折脱位型颈脊髓损伤临床应用的可行性及其诊断价值.方法 收集病例组21例无骨折脱位型颈脊髓损伤患者和对照组27例健康志愿者行常规MR及MR-DTI检查,分别测定各向异性分数(fractional anisotropy,FA)值、表观弥散系数(apparent diffusion coefficient,ADC)值.结果 正常人颈髓MR-DTI的FA值=0.645±0.016,ADC值=(0.919±0.017)×10-3mm2/s.无骨折脱位型颈脊髓损伤MR-DTI的FA值=0.501±0.022,ADC值=(1.008±0.287)×10-3 mm2/s；与对照组对比:无骨折脱位型颈脊髓损伤中FA值明显降低,两者的差异具有统计学意义(P＜0.05),而ADC值略增高,两者的差异无统计学意义(P＞0.05).结论 DTI可以更加敏感的探测到无骨折脱位型颈脊髓损伤的发生,可为颈髓损伤程度的评估提供有价值的信息.

Clinical application of DTI for cervical spinal cord injury without radiographic abnormality

Objective To investigate the feasibility of clinical application and diagnostic value of MR diffusion tensor ima- ging （MR-DTI） in patients with cervical spinal cord injury without radiographic abnormality （SCIWORA）. Methods To- tal of 21 patients with cervical SCIWORA and 27 healthy volunteers were selected prospectively. The scan sequences in- cluded conventional scans and DTI. The values of FA （Fractional Anisotropy） and ADC （Apparent Diffusion Coefficient） were measured using Functool software. Results The FA and ADC values of the healthy controls were 0. 645±0. 016 and （0. 919±0. 017）×10^-3mm^2/s respectively. Whereas, the FA and ADC values of patients with cervical SCIWORA were 0. 501 ± 0. 022 and （1. 008 ±0. 287） ×10^-3mm^2/s. Compared with the control group, the cervical SCIWORA cases had sig- nificantly lower FA values （ P 〈0.05） and not significantly higher ADC values （ P 〉0.05）. Conclusion DTI can sensi- tively detect the cervical SCIWORA that the conventional T2-weighted images failed to reveal. MR-DTI can provide more valuable information to evaluate the severity of cervical SCIWORA.