扩散加权成像在脊髓型颈椎病中的应用

目的:研究扩散加权成像(DWI)在脊髓型颈椎病(CSM)中的应用价值。方法:30例临床及影像学证实为CSM患者,行颈髓MRI和扩散加权成像,分析病变表现并测量其ADC值。结果:30例中除2例因伪影明显未行ADC值测量外,余28例均成功行DWI及ADC值测量。CSM的MRI主要表现为颈椎曲度异常、椎体骨质增生、椎间盘突出、后纵韧带及黄韧带增厚等,相应部位的脊髓均有不同程度的受压改变,伴有椎管狭窄者20例。T2WI脊髓受压部位出现高信号者18例,其中16例DWI相应部位均表现为ADC值增高,2例表现为ADC值略减低;10例T2WI未见异常信号者中有5例亦表现为脊髓受压部位不同程度的ADC值增高。3例手术后复查DWI显示病变部位ADC值不同程度减低。结论:DWI对CSM的早期诊断具有较高的敏感性,且可以在手术疗效监测方面发挥重要作用。

Application of Diffusion Weighted Imaging in Cervical Spondylotic Myelopathy

Objective:To study the role of diffusion weighted imaging (DWI) in the clinical application of cervical spondylotic myelopathy.Methods:Cervical MRI and DWI were performed on a Philips Gyroscan Intera 1.5T MR system in 30 patients with cervical spondylotic myelopathy proved by clinical and radiological findings.The MRI findings were analyzed,and the apparent diffusion coefficient (ADC) value were calculated.Results:ADC could be calculated in 28 patients,but could not be calculated in 2 cases because of poor signal to noise ratio and marked artifact.Conventional MRI findings included abnormal cervical curvature,hyperostosis,intervertebral disc protrusion,thickening of posterior longitudinal ligament and ligamenta flava.Spinal cord compression were seen in all of these cases,while 20 of them were accompanied with cervical canal narrowing (sagittal dimension of spinal canal <1cm).There were 18 cases showed hyper-intensity on T_2WI,while 16 cases showed increased ADC value in the region of spinal cord compression.No T_2WI abnormalities was shown in 10 cases.Among these,five cases had increased ADC value at the region of spinal cord compression,showing the sensitivity of DWI was higher than that of conventional MRI.Three patients with surgical decompression operation had follow-up MRI and DWI examinations,various degree of decreased ADC value was showed when compared with that before surgery.Conclusion:DWI proved to be more sensitive in the early diagnosis of cervical spondylotic myelopathy and might be helpful in monitoring the effect of treatment.