CAJ | 학술논문

目的：探讨3.0T MR 扩散加权成像(DWI)作为定量分析方法在慢性脊髓型颈椎病诊断中的临床价值。方法38例慢性脊髓型颈椎病(CSM)患者与20例志愿者(对照组)行常规颈椎矢状位 T2 WI、横断位 DWI 扫描，并重建矢状位表观扩散系数(ADC)图像；计算各组脊髓 T2 WI 高信号例数并测量脊髓 ADC 值；CSM 组分别测量脊髓 C3水平、受压或信号异常部位以及 T1~T2水平 ADC 值，对照组测量 C3、C4~C6、T1~T2水平脊髓 ADC 值。结果 CSM 组Ⅰ~Ⅳ级分别有3例、1例、6例、8例出现脊髓高信号，对照组2例出现脊髓 T2 WI 高信号；脊髓受压部位 ADC 值随 CSM 分级增高而逐渐增高，对照组、CSM 组Ⅰ~Ⅱ级与 CSM Ⅳ级之间 ADC 均值差别有统计学意义。结论 CSM 患者脊髓 ADC 值改变要早于脊髓信号的改变；ADC 值可以反映 CSM 患者脊髓的受压程度。
목적：탐토3.0T MR 확산가권성상(DWI)작위정량분석방법재만성척수형경추병진단중적림상개치。방법38례만성척수형경추병(CSM)환자여20례지원자(대조조)행상규경추시상위 T2 WI、횡단위 DWI 소묘，병중건시상위표관확산계수(ADC)도상；계산각조척수 T2 WI 고신호례수병측량척수 ADC 치；CSM 조분별측량척수 C3수평、수압혹신호이상부위이급 T1~T2수평 ADC 치，대조조측량 C3、C4~C6、T1~T2수평척수 ADC 치。결과 CSM 조Ⅰ~Ⅳ급분별유3례、1례、6례、8례출현척수고신호，대조조2례출현척수 T2 WI 고신호；척수수압부위 ADC 치수 CSM 분급증고이축점증고，대조조、CSM 조Ⅰ~Ⅱ급여 CSM Ⅳ급지간 ADC 균치차별유통계학의의。결론 CSM 환자척수 ADC 치개변요조우척수신호적개변；ADC 치가이반영 CSM 환자척수적수압정도。
Objective To explore the value of diffusion weighted imaging (DWI)as a quantitative analysis tool for chronic cervical spondylotic myelopathy (CSM)with 3.0T MRI.Methods Cervical routine MR T2-weighted imaging(T2 WI)and diffusion weighted imaging were performed in 38 patients with cervical spondylotic myelopathy (CSM group)and 20 healthy volunteers (control group),and sagittal image of apparent diffusion coefficient (ADC)was reconstructed.The number of high T2 signal of the spinal cord were calculated in both healthy volunteers and CSM patients.The ADC values of CSM groups were measured in C3,T1 -C2 level and the compression or abnormal signal parts of the spinal cord;the control group measured C3、C4-C6 and T1 -T2 level in the spinal cord.Results There were 3 cases,1 case,6 cases and 8 cases high T2 signals in CSM patients from Ⅰ to Ⅳ levels,while there were 2 cases show high T2 signals in control group,respectively.The mean ADC values of the compression part were gradual-ly increased in CSM group from Ⅰ to Ⅳ level.There were significant differences of the mean ADC values of compression part be-tween the control group,CSMⅠ-Ⅱ level and the CSM Ⅳ level.Conclusion From our study,the change of ADC value of spine cord occured earlier than the change of signal in CSM patients.Therefore,the ADC value of spine cord might reflect the degree of spinal cord compression from CSM patients.