转移瘤脊髓压迫症运动功能损害与影像学特征的相关性
전이류척수압박증운동공능손해여영상학특정적상관성
Relationship of motor deficits and imaging features in metastatic epidural spinal cord compression
  • 万方数据
    中华医学杂志 중화의학잡지
    National Medical Journal of China
    2010年 23期 1606-1608 ,共3页

    刘蜀彬%刘耀升%李鼎锋%范海涛%槐建业%郭钧%王磊%刘铖%张平%崔秋%姜维浩%曹云岑%江宁%隋佳红%张斌%周举

    류촉빈%류요승%리정봉%범해도%괴건업%곽균%왕뢰%류성%장평%최추%강유호%조운잠%강저%수가홍%장빈%주거

    肿瘤转移%硬膜外肿瘤%运动障碍 腫瘤轉移%硬膜外腫瘤%運動障礙
    종류전이%경막외종류%운동장애
    Neoplasm metastasis%Epidural neoplasm%Movement disorders
    目的 探讨转移瘤硬膜外脊髓压迫症(MESCC)运动功能损害与影像学特征的相关性.方法 自2006年7月至2008年12月,对连续收治的56例MESCC患者入院后按Frankel分级进行瘫痪状态评估,并进行主要病变脊椎的MRI及CT扫描.主要病变脊椎影像学评估因素包括:病变脊椎节段、侵犯硬膜外间隙、累及椎板、椎体后壁向后突出、病变脊椎连续、累及椎弓根、椎体前柱骨折、椎体后壁骨折、病变脊椎位于上胸椎和(或)颈胸交界.结果 本组56例MESCC患者瘫痪状态与侵犯椎管内硬膜外组织的影像学特征发生状况完全一致.多元回归方程表明MESCC瘫痪状态与累及椎板(X1)、椎体后壁向后突出(X2)、病变脊椎位于颈胸交界处和上胸椎(X7)等影像学特征存在线性回归关系.MESCC瘫痪状态(Y)与影像学特征(X)的最优回归方程为Y=-0.009+0.639X1+0.149X2+0.282X7,其中累及椎板对MESCC瘫痪状态影响最大.结论 影像学特征中累及椎板、椎体后壁向后突出、病变脊椎位于上胸椎和(或)颈胸交界可预测MESCC的瘫痪状态,累及椎板的MESCC患者最易向硬膜外间隙侵犯.
    목적 탐토전이류경막외척수압박증(MESCC)운동공능손해여영상학특정적상관성.방법 자2006년7월지2008년12월,대련속수치적56례MESCC환자입원후안Frankel분급진행탄탄상태평고,병진행주요병변척추적MRI급CT소묘.주요병변척추영상학평고인소포괄:병변척추절단、침범경막외간극、루급추판、추체후벽향후돌출、병변척추련속、루급추궁근、추체전주골절、추체후벽골절、병변척추위우상흉추화(혹)경흉교계.결과 본조56례MESCC환자탄탄상태여침범추관내경막외조직적영상학특정발생상황완전일치.다원회귀방정표명MESCC탄탄상태여루급추판(X1)、추체후벽향후돌출(X2)、병변척추위우경흉교계처화상흉추(X7)등영상학특정존재선성회귀관계.MESCC탄탄상태(Y)여영상학특정(X)적최우회귀방정위Y=-0.009+0.639X1+0.149X2+0.282X7,기중루급추판대MESCC탄탄상태영향최대.결론 영상학특정중루급추판、추체후벽향후돌출、병변척추위우상흉추화(혹)경흉교계가예측MESCC적탄탄상태,루급추판적MESCC환자최역향경막외간극침범.
    Objective To explore the relationship of motor deficits of the lower extremities with the imaging features of malignant spinal cord compression(MESCCs).Methods From July 2006 through December 2008,56 successive MESCC patients were treated at our department.All were evaluated by magnetic resonance imaging and computed tomography and were scored according to motor deftcits Frankel grading on admission.Imaging assessment factom of main involved vertebrae were level of vertebral metastastic location,epidural space involvement,vertebral body involvement,lamina involvement,posterior protrusion of posterior wall,pedicle involvement,continuity of main involved vertebrae,fracture of anterior column,fracture of posterior wall,location in upper thoracic spine and/or cervicothoracic iunction.Results Occurrence was the same between paralytic state of MESCCs and epidural space involvement of imaging features.Multiple regression equation showed that paralytic state had a linear regression relationshiD with imaging factors of lamina involvement(X1),posterior protrusion of posterior wall(X2),location in upper thoracic spine and/or cervicothoracic junction(X7)of main involved vertebrae.The optimal regression equation of paralytic state(Y) and imaging feature (X) was Y=-0.009+0.639X1+0.149X2+0.282X.Lamina involvement of main involved vertebrae has a greatest influence upon paralytic state of MESCC patients.Conclusions Imaging factors of lamina involvement,posterior protrusion of posterior wall,location in upper thoracic spine and/or cervicothoracic junction of main involved vertebrae can predict the paralytic state of MESCC patients.MESCC with lamina involvement is more easily encroached on epidural space.
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