CAJ | 학술논문

近年来，颈脊髓MRI中T2WI髓内高信号（ISI）的形态及程度的变化一直被视为颈脊髓压迫性疾病治疗效果的一项预测指标。但是，目前对于颈椎MRI T2WI ISI的临床和影像学意义仍存在争议，原因之一是缺乏评价MRI信号强度的理想分析方法。明确脊髓型颈椎病（CSM）术前T2WI ISI的类型对于判断预后具有一定的指导价值。当前更倾向于认为术前多节段T2WI ISI或清晰高亮型T2WI ISI信号往往意味着预后较差，而术后减弱的T2WI ISI信号可能会有更好的预后。本文就近年来关于颈脊髓内高信号与CSM预后关系报道进行复习，在其发生的病理基础、影像分型及其与临床预后的相关性等方面作一综述，以便更充分地了解这种信号变化（T2WI ISI）在颈椎疾患治疗中对预后判断的意义。
근년래，경척수MRI중T2WI수내고신호（ISI）적형태급정도적변화일직피시위경척수압박성질병치료효과적일항예측지표。단시，목전대우경추MRI T2WI ISI적림상화영상학의의잉존재쟁의，원인지일시결핍평개MRI신호강도적이상분석방법。명학척수형경추병（CSM）술전T2WI ISI적류형대우판단예후구유일정적지도개치。당전경경향우인위술전다절단T2WI ISI혹청석고량형T2WI ISI신호왕왕의미착예후교차，이술후감약적T2WI ISI신호가능회유경호적예후。본문취근년래관우경척수내고신호여CSM예후관계보도진행복습，재기발생적병리기출、영상분형급기여림상예후적상관성등방면작일종술，이편경충분지료해저충신호변화（T2WI ISI）재경추질환치료중대예후판단적의의。
Intramedullary signal intensity (ISI) changes in morphology and extent of T2-weighted (T2W) in preopera?tive cervical magnetic resonance (MR) images was thought to be indicative to the prognosis of cervical spondylotic myelopa?thy (CSM) in recent years. However, the significance of ISI changes in predicting CSM prognosis remains controversial. Lack of satisfied evaluating approch of ISI on magnetic resonance imaging (MRI) is the main drawback. Identification of the type of T2WI ISI on preoperative MR imaging could give important information in predicting surgical outcome of patients with CSM. Currently, consensus is reached that preoperative multi-segmental T2WI ISI or sharp T2WI ISI indicate a worse prognosis for patients with CSM compared with regression of T2WI ISI. The literatures that link magnetic resonance imaging signal changes with prognosis of surgery to correct cervical spondylotic myelopathy are reviewed. The correlation of pathological changes and radiological performance of intramedullary signal intensity with prognosis of CSM are summarized to understand the significance of T2WI ISI on prognosis of surgical outcome.