脊髓型颈椎病患者小视野扩散张量成像参数与临床评价的相关性

目的 探讨脊髓型颈椎病(CSM)患者颈脊髓的扩散张量参数变化特点及与临床评分的相关性。 方法 收集39例临床诊断明确的CSM患者(病例组),以21名无脊髓功能损害的志愿者作为对照组,行常规颈椎MR检查及小FOV DTI,分别测量病例组C_2~3水平、病变水平及对照组C_2~3、C_3~7水平FA值及平均扩散系数(MD)值,并对CSM患者进行JOA问卷调查。 结果 病例组脊髓受压水平FA值明显低于对照组C_3~7水平FA值(P<0.05),C_3~7各水平FA值组间比较差异有统计学意义(P<0.05);病例组病变水平MD值明显高于对照组C_3~7水平MD值(P<0.05)。病例组C_3~4和C_4~5水平FA值与JOA评分呈明显正相关(r=0.633,P=0.003;r=0.446,P<0.05)。 结论 CSM患者病变水平FA值明显减低,C_3~5水平FA值随CSM患者临床症状的加重而减低。

Correlation of reduced field-of-view diffusion tensor imaging with clinical assessment of disease severity in cervical spondylotic myelopathy

Objective To obtain microstructural parameters of cervical spinal cord in cervical spondylotic myelopathy (CSM) patients, and to compare DTI parameters with clinical score. Methods DTI was performed on 39 symptomatic patients with CSM (patients group) and 21 matched volunteers (control group). FA and mean diffusivity (MD) were calculated at C_2-3 level and compressed level in patients and at C_2-3, C_3-7 in controls. CSM patients were clinically evaluated using a self-administered questionnaire. Results FA values of patients group were significantly lower at the compressed level than that of control group at C_3-7 level (P<0.05). FA values of the two groups were significantly different at all levels of tC_3-7 (P<0.05). MD values of patients were significantly higher at the compressed level than that of control group at C_3-7 level (P<0.05). Significant positive correlation between FA at C_3-4 and C_4-5 compressed level and clinical score were demonstrated (r=0.633, P=0.003; r=0.446, P<0.05), respectively. Conclusion FA values of patients are significantly lower at the compressed level than that of volunteers at C_3-7 level. FA values decreases with aggravated symptoms of CSM.