磁共振扩散张量成像在颈髓病变中的应用

目的：探讨磁共振扩散张量成像（DTI）技术在颈髓病变诊断中的临床应用。方法：应用1.5T磁共振机器对39例颈髓病变患者和15例健康志愿者行MRI常规和DTI检查,测定病变区和对照部位的FA值、ADC值并进行对照分析,并重建白质纤维束图。结果：健康志愿者颈髓的FA值为0.66±0.06,ADC值为（0.96±0.14）×10^-3mm^2/s。颈椎病病例FA值为0.47±0.05、ADC值为（1.16±0.28）×10^-3mm^2/s;与对照组统计学分析FA值明显降低（P〈0.01）,ADC值明显增高（P〈0.01）。颈髓急性损伤病例FA值为0.38±0.08、ADC值为（0.89±0.25）×10^-3mm^2/s;与对照组统计学分析FA值明显降低（P〈0.01）,ADC值与对照组无明显差异（P=0.130〉0.05）。颈髓炎症：FA值为0.40±0.06、ADC值为（1.25±0.40）×10^-3mm^2/s;与对照组统计学分析FA值明显降低（P〈0.01）,ADC值明显增高（P〈0.01）。所有病例通过DTI技术成功显示了白质纤维束在病变区变形、移位及中断等改变。结论：DTI可以探测到颈髓病变中常规MR未能发现的病灶;白质纤维束成像可以显示白质束的受损情况。

Clinical application of MR diffusion tensor imaging in cervical cord diseases

Objective：To investigate the clinical application of MR diffusion tensor imaging （DTI） in cervical cord lesions.Methods：39 patients with clinical diagnosis and 15 healthy volunteers underwent MRI and DTI by using a 1.5T MR scanner.The values of fractional anisotropy （FA） and apparent diffusion coefficient （ADC） were measured in both heathy subjects and patients,and the white matter fibertracts were performed in each patient.Results：The FA and ADC values of normal cervical cord were 0.66±0.06 and （0.96±0.14）×10^-3mm^2/s,the FA and ADC values of the patients with cervical spondylotic myelopathy （CSM） were 0.46±0.05 and （1.20±0.29）×10^-3mm^2/s,there was a statistically significant difference in the FA and ADC values between volunteers and CSM patients （P〈0.01）.The FA and ADC values of the patients with acute cervical cord injury （CCI） were 0.38±0.08 and （0.89±0.25）×10^-3mm^2/s,the FA values between volunteers and CCI patients had statistically significant difference （P〈0.01）,the ADC values had no statistically significant difference （P=0.075〉0.05）.The FA and ADC values of the patients with the inflammatory disease of spinal cord were 0.40±0.06 and （0.96±0.14）×10^-3mm^2/s,there was a statistically significant difference in the FA and ADC values between volunteers and inflammatory disease of spinal cord.The fiber tracts showed the abnormal areas of the white matter,including displacement and interruption.Conclusion：DTI can detect the lesions of cervical cord,whereas T2WI findings were normal.Spinal cord fiber tracking can provide useful information for studying pathologic aspects on the cervical cord abnormalities.