摘要
目的探究扩散张量成像(diffusion tensor imaging,DTI)量化值对脊髓型颈椎病患者术后神经功能预后的相关性。材料与方法选取2017年5月至2018年8月我院医学影像科收治的102例脊髓型颈椎病患者进行研究。患者均进行脊髓型颈椎病减压术,根据患者术后神经功能恢复情况分为良好组[日本骨科学会(Japanese Orthopaedic Association,JOA)恢复率≥60%]49例和不良组(JOA恢复率<60%)53例,观察DTI量、术后JOA评分,分析DTI量化值与JOA的关系。结果良好组存在T2WI高信号比例低于不良组,差异显著(χ2=17.21,P<0.01)。良好组术后各向异性分数(fractional anisotropy,FA)值高于不良组,术后ADC值低于不良组,差异显著(t=3.59、6.38,P<0.001)。两组术后λ∥值、λ⊥值比较无显著差异(t=0.592、1.321,P=0.554、0.189)。良好组术后JOA评分与JOA恢复率明显高于不良组,差异显著(t=7.22、15.1,P<0.0 0 1)。经相关性分析得到,术后FA值与术后J O A评分呈正相关(r=0.5 3, P <0.001),术后ADC值与JOA恢复率呈负相关(r=-0.42,P<0.001),术后λ⊥值与JOA恢复率呈负相关(r=-0.39,P=0.03)。结论 DTI量化值与脊髓型颈椎病患者术后神经功能恢复有关,DTI量化值与术后JOA评分有关,DTI量化值能够体现脊髓病理状态,并对术后神经功能预后具有预测价值。
Objective:To investigate the correlation between the quantitative values of magnetic resonance diffusion tensor imaging(DTI)and the neurological prognosis in patients with cervical spondylotic myelopathy(CSM).Materials and Methods:A total of 102 patients with cervical spondylotic myelopathy treated in our medical imaging department from May 2017 to August 2018 were enrolled to receive decompression for cervical spondylotic myelopathy,and were divided into good group[Japanese Orthopaedic Association(JOA)recovery rate≥60%,n=49]and poor group(JOA recovery rate<60%,n=53)according to the postoperative neurological recovery.The amount of DTI and the postoperative JOA score were observed,and the relationship between the quantitative DTI and JOA was also analyzed.Results:The proportion of T2 WI high signal in the good group was lower than that in the poor group(χ^2=17.21,P<0.01).The postoperative fractional anisotropy(FA)in the good group was higher than that in the poor group,and the apparent diffusion coefficient(ADC)was lower in the postoperative group than in the poor group(t=3.59,6.38,P<0.001).There was no significant difference inλ∥value andλ⊥value between the two groups after surgery(t=0.592,1.321,P=0.554,0.189).The JOA score and JOA recovery rate in the good group were significantly higher than those in the poor group(t=7.22,15.1,P<0.001).Correlation analysis showed that postoperative FA value was positively correlated with postoperative JOA score(r=0.53,P<0.001),that postoperative ADC value was negatively correlated with JOA recovery rate(r=-0.42,P<0.001),and that postoperativeλ⊥value was negatively correlated with JOA recovery rate(r=-0.39,P=0.03).Conclusions:The quantitative DTI value is related to the postoperative neurological recovery and postoperative JOA score in patients with cervical spondylotic myelopathy,which can reflect the pathological state of the spinal cord and has a predictive value for the postoperative neurological function.
作者
郭瑞敏
汪杜
杨卫
GUO Ruimin;WANG Du;YANG Wei(Department of Imaging,Tianyou Hospital Affiliated to WuHan University of Science&Technology,Wuhan 430000,China)
出处
《磁共振成像》
CAS
2020年第12期1152-1155,共4页
Chinese Journal of Magnetic Resonance Imaging
关键词
扩散张量成像
量化值
脊髓型颈椎病
术后神经功能预后
表观扩散系数
diffusion tensor imaging
quantized value
cervical spondylotic myelopathy
postoperative neurological prognosis
apparent diffusion coefficient
