| 取比值后弥散张量成像参数对脊髓型颈椎病的诊断价值 |
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| 作者姓名： | 姚瑞鑫 郭会利 张斌青 叶艳君 |
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| 作者单位： | 1.河南中医药大学第三临床学院，河南 郑州 4500462.河南省洛阳正骨医院（河南省骨科医院）影像中心，河南 洛阳 471002 |
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| 基金项目： | 河南省中医药科学研究专项课题2016ZY2024 |
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| 摘 要： | 目的 探究自身对比后磁共振弥散张量成像（DTI）参数对脊髓型颈椎病的诊断价值。 方法 选取2020年10月~2021年5月本院收治的56例脊髓型颈椎病患者作为病例组，同时选取62名健康志愿者作为健康组。对纳入的受试者均进行DTI成像，对不同节段颈髓参数均与颈2/3段取比值，对比健康组取比值前后各向异性分数（FA）和表观扩散系数（ADC）的差异性，探究取比值方式是否可以减小DTI成像参数的个体差异。将取比值后健康组与病例组的参数作对比，并结合常规磁共振测量脊髓纵横比，分析FA和ADC与脊髓纵横比的相关性，最后通过绘制受试者操作特征曲线，判断取比值后FA和ADC对脊髓型颈椎病的诊断效能并给出诊断临界值。 结果 健康组的FA与ADC值存在个体差异性，取比值后健康组FA与ADC的个体差异性消失（P > 0.05）。健康组和病例组对比，病例组的比值后FA降低而ADC增高，并且病例组比值后FA与脊髓纵横比成中度正相关（r= 0.617，P < 0.05），比值后ADC与脊髓纵横比呈低度负相关（r=-0.478，P < 0.05）。绘制受试者操作特征曲线显示，比值后FA对脊髓型颈椎病的诊断效能为0.821，临界值为0.917；ADC对脊髓型颈椎病的诊断效能为0.791，临界值为1.140，两者联合的诊断效能为0.896。 结论 对DTI参数取比值后可以减少个体差异的影响，在诊断脊髓型颈椎病方面更有临床实用意义；取比值后FA和ADC与脊髓压缩纵横比有一定的相关性。
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| 关 键 词： | 脊髓型颈椎病 MRI 磁共振弥散张量成像 |
| 收稿时间： | 2021-09-13 |
Diagnostic value of diffusion tensor imaging parameters after ratio in cervical spondylotic myelopathy |
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| Authors: | YAO Ruixin GUO Huili ZHANG Binqing YE Yanjun |
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| Affiliation: | 1.Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450046, China2.Imaging Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang 471002, China |
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| Abstract: | Objective To investigate the diagnostic value of diffusion tensor imaging (DTI) parameters after self- contrast in cervical spondylotic myelopathy. Methods Fifty-six patients with cervical spondylotic myelopathy admitted to our hospital from October 2020 to May 2021 were selected as the case group, while 62 healthy volunteers were selected as the healthy group. DTI imaging was performed in all included subjects, and the ratios of cervical spinal cord parameters to cervical 2/3 segments were taken to compare the differences in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) before and after taking the ratios in healthy groups, and to explore whether taking the ratio method can reduce individual differences in DTI imaging parameters. The parameters of the healthy case group after taking the ratio were compared. The spinal cord aspect ratio was measured in combination with conventional magnetic resonance. The correlation between FA and ADC and spinal cord aspect ratio was analyzed. Finally, the diagnostic efficacy of FA and ADC for cervical spondylotic myelopathy after taking the ratio was judged and the diagnostic cut-off value was given by plotting the receiver operating characteristic curve. Results There were individual differences in FA and ADC values in the healthy group, and the individual differences in FA and ADC in the healthy group disappeared after taking the ratio (P > 0.05). Compared with the healthy group, FA decreased and ADC increased after the ratio in the case group, and there was a moderate positive correlation between FA and spinal cord aspect ratio after the ratio in the case group (r=0.617, P < 0.05), and a low negative correlation between ADC and spinal cord aspect ratio after the ratio (r=-0.478, P < 0.05). The diagnostic efficacy of FA for cervical spondylotic myelopathy was 0.821 and the cut-off value was 0.917 after the ratio. The diagnostic efficacy of ADC for cervical spondylotic myelopathy was 0.791 and the cut-off value was 1.140. The diagnostic efficacy of the combination of the two was 0.896. Conclusion The ratio of DTI parameters can reduce the influence of individual difference, and has more clinical practical significance in the diagnosis of cervical spondylotic myelopathy. The ratio of FA and ADC has certain correlation with the compression aspect ratio of spinal cord. |
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