颈椎管狭窄症的磁共振成像研究

目的：比较分析手术证实颈椎管狭窄症的MRI及X线和临床资料，明确颈椎管狭窄症的MRI概念及分型．材料和方法：对一组47例MRI进行各节段颈髓腹侧代偿间隙、颈髓和颈髓背侧代偿间隙矢状径测量;X线片上测量椎体、椎臂矢状径并计算Torg指数；采用JOA十七分法作临床评分。对MRI及X线和临床资料进行相关分析．结果：MRI示颈椎管狭窄患者的颈髓腹背侧代偿间隙、颈髓矢状径均减小，以病变节段最明显。MRI对临床表理的预示能力优于X线。MRI可以就狭窄范围、狭窄方向、狭窄程度和髓内信号改变行详尽分型．结论：颈椎管狭窄的MRI特征变化为正中矢状面上蛛网膜下腔减少或消失．和／或伴有脊髓的压迫变形，髓内信号异常．分类更准确地反映病理解剖及病理生理改变,密切地联系了临床，对颈椎管狭窄症的准确诊断和治疗选择有指导意义．

MRI study of Cervical Stenosis

Purpose: MR imaging,x-ray films and clinical findings were correalated in degenerative cervical stenosis to modify its MRI concept and MRI classification. Material and Methods:In a group of 47 patients who uderwent operation for degenerative cervical stenosis, the reserve space, saggital diameter of spinal cord on T2 weighted imaging, saggital diameter of cervical vertebral body and canal on X-ray films were measured and Torg's Index were calculated, clinical manifestation were evaulated by means of JOA score, these data were correalated. Result: The reserve space, saggital diameter of spinal cord decrease on T2 weighted imaging,especiially in the diseased segments.MRI can indicate the clinical manifestation better than X-ray films. MRI classification of degenerative cervical stenosis was established according to the segments involved,compression direction,compression degree and the abnormal changes within spinal cord. Conclusion: The MRI characteristic changes of degenerative cervical stenosis were the subarachnoid space decrease or vanish,compression of spinal cord and abnormal signal within spinasl cord. The MRI classification can indicate the abnormal pathological anatomy changes and clinical changes and guide the diagnosis and operation.