CAJ | 학술논문

[目的]探讨脊髓型颈椎病（CSM ）患者术前脊髓M RI的 T2 WI高信号的类型是否可预测椎体次全切除术后的疗效。[方法]回顾性分析148例行椎体次全切除术的CSM 患者的术前颈髓矢状位 T1 WI与T2 WI信号的改变，采用 Nurick分级的改变程度来评价CSM 的术后疗效，并对 Nurick分级变化≥Ⅰ级或Nurick 0～Ⅰ级病例与T2 WI信号类型进行logistic回归分析。[结果]64例（15．2％）为0型，48例（32．4％）为Ⅰ型，36例（24．3％）为Ⅱ型；术前Nurick 4～5级和Ⅱ型信号与术后治愈的可能性均存在明显的负相关；T1 WI低信号仅见于Ⅱ型信号患者，在36例Ⅱ型信号患者中，15例出现T1 WI低信号且与术后治愈存在明显的负相关。[结论]Ⅱ型信号与CSM患者治愈的可能性存在负相关，而在Ⅱ型信号的病例中 T1 WI低信号可作为预测术后低治愈率的指标。
[목적]탐토척수형경추병（CSM ）환자술전척수M RI적 T2 WI고신호적류형시부가예측추체차전절제술후적료효。[방법]회고성분석148례행추체차전절제술적CSM 환자적술전경수시상위 T1 WI여T2 WI신호적개변，채용 Nurick분급적개변정도래평개CSM 적술후료효，병대 Nurick분급변화≥Ⅰ급혹Nurick 0～Ⅰ급병례여T2 WI신호류형진행logistic회귀분석。[결과]64례（15．2％）위0형，48례（32．4％）위Ⅰ형，36례（24．3％）위Ⅱ형；술전Nurick 4～5급화Ⅱ형신호여술후치유적가능성균존재명현적부상관；T1 WI저신호부견우Ⅱ형신호환자，재36례Ⅱ형신호환자중，15례출현T1 WI저신호차여술후치유존재명현적부상관。[결론]Ⅱ형신호여CSM환자치유적가능성존재부상관，이재Ⅱ형신호적병례중 T1 WI저신호가작위예측술후저치유솔적지표。
[Objective]To explore whether different types of high signals on spinal T2WI in patients with cervical spondylotic myelopathy (CSM ) before surgery can predict the outcome after subtotal corpectomy .[Methods] The changes of sagittal T1 WI and T2 WI signals of 148 CSM patients undergoing subtotal corpecto-my before operation were analyzed retrospectively . Postoperative efficacy was evaluated by the change of Nurick grade .The types of T2WI signals in patients with Nurick grade ≥1 or Nurick 0~I were analyzed by logistic regression method .[Results] There were 64 patients(15 .2% ) with type 0 ,48 patients(32 .4% ) with type Ⅰ and 36 patients(24 .3% ) with type Ⅱ .Preoperative Nurick Ⅳ ~ Ⅴ and type Ⅱ signal had obviously positive correlation with the possibility of the cure after surgery .Low T1 WI signal was only seen in patients with type Ⅱ signal .Of 36 patients with type Ⅱ signal ,low T1 WI signal was seen in 15 patients and negatively correlated with the cure after surgery .[Conclusion] Type Ⅱ signal is negatively correlated with the possibility of the cure in CSM patients ,but low T1 WI signal in patients with type Ⅱ signal can be used as the index of predicting the low curative rate after surgery .