CAJ | 학술논문

目的：探讨平山病的临床特征及颈椎自然体位、屈曲体位平扫及增强扫描在平山病中的诊断价值。方法回顾性分析临床确诊的15例平山病患者的临床资料及MRI影像表现，15例均行MRI自然体位、屈曲体位平扫及增强扫描。结果15例均符合临床诊断标准，全部为男性，平均年龄19.8岁。自然体位颈椎MRI表现为生理曲度伸直或反弓，椎间盘退变，下颈椎脊髓信号异常，椎弓根水平横断面下颈椎硬膜囊与椎板分离；屈曲体位颈椎MRI平扫表现为下颈椎颈髓萎缩、变扁，后方硬膜囊向前移位，局部颈髓受压、变细，背侧硬膜外间隙增宽，内见新月状长T1、长T2异常信号影，增强后呈明显条状强化，增宽的硬膜外间隙内可有异常血管流空信号。结论平山病好发于青春期男性，具有特殊的临床特征，屈曲体位颈椎MRI虽具有特征性影像表现，对平山病的诊断具有高度的准确性，但是自然体位颈椎MRI影像表现不可忽视，两者在平山病的诊断中均具有重要价值。
목적：탐토평산병적림상특정급경추자연체위、굴곡체위평소급증강소묘재평산병중적진단개치。방법회고성분석림상학진적15례평산병환자적림상자료급MRI영상표현，15례균행MRI자연체위、굴곡체위평소급증강소묘。결과15례균부합림상진단표준，전부위남성，평균년령19.8세。자연체위경추MRI표현위생리곡도신직혹반궁，추간반퇴변，하경추척수신호이상，추궁근수평횡단면하경추경막낭여추판분리；굴곡체위경추MRI평소표현위하경추경수위축、변편，후방경막낭향전이위，국부경수수압、변세，배측경막외간극증관，내견신월상장T1、장T2이상신호영，증강후정명현조상강화，증관적경막외간극내가유이상혈관류공신호。결론평산병호발우청춘기남성，구유특수적림상특정，굴곡체위경추MRI수구유특정성영상표현，대평산병적진단구유고도적준학성，단시자연체위경추MRI영상표현불가홀시，량자재평산병적진단중균구유중요개치。
Objective To investigate the clinical characteristics of Hirayama disease and the diagnostic val-ue of plain scan in the neck neutral and flexion position and enhanced scanning in Hirayama disease. Methods Clini-cal data and MRI findings of 15 Hirayama disease cases were retrospectively analyzed. All 15 cases received plain scan in the neck neutral and flexion position and enhanced scanning. Results 15 cases were consistent with the clini-cal diagnostic criteria, and all of them were male with an average age of 19.8 years old. Their MRI of cervical spine in the neutral position all showed straight or reverse physiological curvature, degeneration of the intervertebral disc, cer-vical spinal cord signal abnormalities, separation of cervical vertebral dural sac and plate under the transverse section of vertebral pedicle;while in the neck flexion position, their MRI scans showed lower cervical spine and spinal cord at-rophy and flattened, forward displacement of the dural sac, local cervical spinal compressed and thinned, dorsal epidur-al gap widened, crescent long T1WI, long T2WI abnormal signal, clearer strip after enhancement, abnormal vascular flow void signal within the widened epidural space. Conclusion Hirayama disease occurs mainly in adolescent males and has special clinical features. Although the cervical MRI in neck flexion position has characteristic imaging findings and, was accurate in the diagnosis of Hirayama disease, the cervical MRI in neck neutral position can not be ignored in the diagnosis of Hirayama disease. Therefore both of them are significantly valuable in the diagnosis of Hi-rayama disease.