摘要
目的 探讨平山病低位颈髓在自然位和过屈位特殊的动态变化对诊断的价值。方法 对18例临床确诊为平山病的患者和31例正常对照者进行MR自然位和过屈位的矢状面和轴面扫描，测量C6椎体上缘颈髓前后径（APD）和横径（TD），观察其动态改变。结果 （1）自然位，平山病组表现有低位颈髓萎缩（病例组11例，对照组2例，X^2=14．76，P=0．000）和变扁平（病例组7例，对照组1例，X^2=8．15，P=0．004），差异有统计学意义。（2）过屈位，平山病组颈髓均前移后显著变扁，脊膜后有“月牙”形异常信号影。（3）自然位平山病组和对照组APD分别为（5．6±0．7）、（6．7±0．5）mm，过屈位APD分别为（4．3±0．8）、（6．0±0．5）mm，差异均有统计学意义（t值分别为-5．802、-8．952，P值均为0．000）。结论 平山病低位颈髓在正常位和过屈位存在特殊的动态变化，过屈位MRI可协助诊断。
Objective To investigate the dynamic changes of the spinal cord during neck flexion in Hirayama disease for diagnosis. Methods MRI examinations in neutral neck position and a fully flexed neck position were performed on 18 cases of Hirayama disease and 31 young normal control subjects. We measured an antero-posterior diameter （APD） and transverse diameter （TD） of the cervical cord at the superior margin of the 05 vertebral body for each position, and investigate the dynamic changes. The different in frequency of these findings between the control and patient groups was examined by means of the X^2 tesL The group means were compared by independent-sample t-tesL Significance was defined as P 〈 0. 05. Results （1） There were significant difference in the frequency of localized lower cervical cord atrophy（ 11 cases with 2 controls, X^2 = 14. 76, P = 0. 000）, asymmetric cord flattening （ 7 cases with 1 controls, X^2 = 8. 15, P = 0. 004）in neutral neck position for Hirayama disease. There was not significant difference in the abnormal cervical curvature between two groups. （2） In a fully flexed position of the neck, all patients and controls showed the lower cervical cord forward displacemenL But, compared with controls, all patients showed flattening of the lower cervical cord, and a ＂crescent-shaped＂ high signal area behind the cord. （ 3 ） In neutral neck position, APD at patients and controls were （5.6 ±0. 7）and （6. 7 ±0. 5）ram respectively（t = - 5. 802, P = 0. 000）. In a fully flexed position, APD at patients and controls were （4. 3 ± 0. 8 ） and（6. 0 ± 0. 5 ）mm respectively （ t = - 8.952, P = 0. 000）. There were significant difference between patients and controls in different position. Conclusion There are obviously changes of the cervical cord during neck flexion in Hirayama disease, which is useful in diagnosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第4期352-355,共4页
Chinese Journal of Radiology
基金
"十五"863基金(2001AA217161)
