颈椎过屈位磁共振成像在平山病诊断中的应用

目的:研究颈椎过屈位MRI对平山病诊断的价值。材料和方法:对13例临床确诊为平山病的患者和10例正常对照者进行颈椎过屈位MRI矢状面和轴面扫描,观察低位脊髓萎缩、变扁、C6椎体上缘水平颈髓前后径及硬膜外异常信号。结果:①低位颈髓的萎缩:病例组9例(69%),对照组1例(10%)。②低位脊髓变扁:仅见于病例组11例(84%),其中有10例(77%)为不对称变扁,脊髓呈"梨形",1例(7%)呈三角形变扁。对照组未出现脊髓变扁的表现。③C6水平颈髓前后径与对照组相比明显变窄,差别有统计学意义(t=-4.54,P<0.05)。④低位颈椎椎管内硬膜后方T_2WI异常信号:仅见于患者组的10例(77%)。结论:颈椎过屈位MRI对诊断平山病有重要的价值。     

不同体位颈椎MRI对平山病的影像诊断

目的 探讨平山病患者自然位和前屈位颈椎MRI表现及其诊断价值.资料与方法 对6例经临床确诊的平山病患者及6名正常自愿者均行颈椎自然位+前屈位+增强MRI,对比分析平山病患者低位颈髓的MRI表现.结果 自然位:6例患者颈椎生理曲度变直,低位颈髓变细;6名正常自愿者可见颈膨大(约脊髓C6～T2段).前屈位:6例患者低位颈髓变扁、萎缩,两种体位低位颈髓前后径差值与正常自愿者相比差异有统计学意义(P<0.05),另可见背侧硬膜囊后壁前移、硬膜外间隙增宽,内见迂曲、条形流空信号,增强后明显强化;正常自愿者低位颈髓较自然位略变细,背侧硬膜囊无前移、扩张,其内未见流空信号.结论 不同体位MRI均能显示平山病患者颈椎的异常表现,尤其是前屈位对平山病的诊断具有重要价值.     

平山病的MRI诊断

目的：探讨平山病（hirayama disease）的MR影像学表现,提高对该病的认识。方法通过查阅相关文献,回顾性分析2例临床已确诊的平山病MR自然位和过屈位影像表现,观察其低位颈髓的动态变化,并与健康自愿者的同条件扫描影像相比较,总结平山病的MR影像学表现。结果①自然位：曲线多有异常,下段颈髓萎缩,髓内可有异常信号,有失连接现象;②过屈位：所有患者均出现颈髓前移、变扁,硬脊膜后有月牙形、集簇状异常信号影;③2例患者强化检查示过屈位脊膜后异常信号影有强化;④志愿者自然位扫描显示颈椎曲度自然,颈髓粗细均匀,不存在失连接现象,过屈位脊膜后无异常信号影。结论MR颈椎检查特别是过屈位扫描能够显示出平山病的特征性影像学改变,对于平山病的早期诊断具有重大价值。     

视神经脊髓炎颈髓常规MRI及扩散张量成像研究

目的通过颈髓常规MRI及扩散张量成像(DTI)观察视神经脊髓炎(neuromyelitis optica,NMO)患者的颈髓病灶表现,并探讨其临床应用价值。方法 20例视神经脊髓炎及20例健康志愿者,行颈髓常规MRI及DTI检查,分析颈髓常规MRI的影像特点,并测量C2~C5水平前索、后索、侧索及灰质感兴趣区的各向异性分数(FA)值及平均扩散率(MD)值,比较两组间差异。结果 NMO患者的脊髓病灶可单纯位于颈髓(20%),或单纯位于胸髓(5%),或颈胸髓内均存在病灶(75%);可为单发(80%)或多发(20%),可呈中心性(70%)或偏心性分布(30%),病灶多呈条片状。在T1WI上,病灶表现为低信号或等信号;T2WI上为高或稍高信号。与正常对照组相比,视神经脊髓炎患者颈髓前索、侧索、后索及灰质的FA值降低,侧索、后索及灰质的MD值升高,且差异均具有统计学意义(均为P0.05)。结论常规MRI可以发现NMO患者脊髓病灶,明确病灶位置及信号特点,DTI能定量检测出其扩散指标的异常,为临床诊断及鉴别诊断提供重要的信息。     

平山病的MRI诊断

目的:总结分析平山病的MRI表现,探讨MRI对平山病的诊断价值。方法:回顾性分析经临床及肌电图证实为平山病的11例患者的影像资料。结果:9例颈椎生理曲度变直或反弓;11例均有MRI上低位颈髓不同程度变扁、变细、萎缩,屈曲位均可见背侧硬脊膜向前移位、后硬脊膜外间隙增宽及弧形或梭形T2WI异常高信号。结论:平山病的MRI表现有一定的特征性,低位颈髓的局限性萎缩、细扁改变、屈曲位后硬脊膜外间隙T2WI高信号及流空信号对本病的诊断具有重要价值。     

平山病2例报告并文献复习

目的 探讨平山病的颈髓磁共振(MRI)表现及其诊断价值.方法 对2例平山病患者的临床、神经电生理、MRI影像学资料进行分析,并复习相关文献,总结平山病的颈髓MRI特点.结果 2例均为青年男性,主要表现为局限于手和前臂肌萎缩.肌电图均示神经源性损害.自然位MRI扫描,2例均有C4～C7段脊髓轻度萎缩,前后径变短.屈颈位MRI平扫2例均可见下段颈髓前移、变扁平加剧,硬脊膜外间隙增宽,其内可见蚓状异常血管流空信号.增强MRI2例均可见增宽的硬膜外间隙内异常增粗并明显强化的静脉丛.结论 平山病的MRI表现有一定的特征性,屈颈位平扫及增强MRI对平山病的诊断有重要的价值.     

平山病的MRI诊断

目的 探讨平山病低位颈髓在自然位和过屈位特殊的动态变化对诊断的价值。方法 对18例临床确诊为平山病的患者和31例正常对照者进行MR自然位和过屈位的矢状面和轴面扫描，测量C6椎体上缘颈髓前后径（APD）和横径（TD），观察其动态改变。结果 （1）自然位，平山病组表现有低位颈髓萎缩（病例组11例，对照组2例，X^2=14．76，P=0．000）和变扁平（病例组7例，对照组1例，X^2=8．15，P=0．004），差异有统计学意义。（2）过屈位，平山病组颈髓均前移后显著变扁，脊膜后有“月牙”形异常信号影。（3）自然位平山病组和对照组APD分别为（5．6±0．7）、（6．7±0．5）mm，过屈位APD分别为（4．3±0．8）、（6．0±0．5）mm，差异均有统计学意义（t值分别为-5．802、-8．952，P值均为0．000）。结论 平山病低位颈髓在正常位和过屈位存在特殊的动态变化，过屈位MRI可协助诊断。     

自然位与过屈位磁共振成像对平山病的诊断价值

目的:探讨颈椎自然位及过屈位磁共振成像对平山病的诊断价值.方法:对8例临床证实的平山病患者行颈椎自然位及过屈位磁共振平扫及增强扫描,所有患者均进行常规脑脊液检查、肌电图检查.结果:自然位MR扫描,8例均有C5～C7段脊髓轻度萎缩,前后径变短,过屈位扫描,7例患者可见颈髓前移,硬脊膜外腔增宽,1例患者可见硬膜外腔内流空血管影,7例在增强扫描中均可见不同程度的硬膜后间隙内异常强化影.结论:平山病患者在过屈位时颈髓及硬膜外腔的异常表现极具特征性,因此MRI过屈位平扫加增强扫描对平山病的诊断具有重要价值.     

平山病MRI诊断价值的初步研究

目的：探讨平山病的MRI表现及其诊断价值,加深对平山病的MRI表现及其可能的发病机制的认识。方法：回顾性分析5例经临床证实为平山病的MRI资料。所有患者均行颈椎常规仰卧位和屈颈位平扫及增强MRI检查。结果：常规仰卧位MPA显示5例患者中3例低位颈髓（C5-C7）萎缩,变扁平,髓内出现信号异常（主要位于灰质前角内）;屈颈位砌平扫5例均可见下段颈髓前移、变扁平加剧;4例硬脊膜外间隙增宽。增强MRI 3例患者可见增宽的硬膜外间隙内异常增粗并明显强化的静脉丛。结论：平山病的MRI表现有一定的特征性,屈颈位平扫及增强MRI对平山病的诊断有重要的价值。     

屈颈MRI对青年性上肢远端肌萎缩症的诊断价值

目的评价屈颈MRI对青年性上肢远端肌萎缩症的诊断价值。方法男性患者5例，平均年龄21岁，临床表现为一侧或两侧上肢远端肌萎缩。对照组为健康志愿者，21岁男性8例。2组均行常规及屈颈颈椎MR平扫，矢状、轴面SET1WI、T2WI、液体衰减反转恢复（FLAIR）序列扫描。结果常规颈椎扫描：5例患者下段颈髓变细；屈颈位MR扫描：下颈段颈6以下脊髓前屈、变扁平，矢状径4～6mm，硬膜囊后壁前移，硬膜后间隙明显增宽，可见多发条状、迂曲流空信号影及软组织信号。对照组：常规扫描，下颈段脊髓（颈6～胸2）可见颈膨大，屈颈位脊髓略变细（6～7mm），硬膜囊后壁无前移，硬膜后间隙未见扩张血管影。结论屈颈MRI有助于显示下颈段脊髓及硬膜囊改变，结合临床资料可准确诊断青年性上肢远端肌萎缩症。     

颈椎管狭窄症的磁共振成像研究

目的：比较分析手术证实颈椎管狭窄症的MRI及X线和临床资料，明确颈椎管狭窄症的MRI概念及分型．材料和方法：对一组47例MRI进行各节段颈髓腹侧代偿间隙、颈髓和颈髓背侧代偿间隙矢状径测量;X线片上测量椎体、椎臂矢状径并计算Torg指数；采用JOA十七分法作临床评分。对MRI及X线和临床资料进行相关分析．结果：MRI示颈椎管狭窄患者的颈髓腹背侧代偿间隙、颈髓矢状径均减小，以病变节段最明显。MRI对临床表理的预示能力优于X线。MRI可以就狭窄范围、狭窄方向、狭窄程度和髓内信号改变行详尽分型．结论：颈椎管狭窄的MRI特征变化为正中矢状面上蛛网膜下腔减少或消失．和／或伴有脊髓的压迫变形，髓内信号异常．分类更准确地反映病理解剖及病理生理改变,密切地联系了临床，对颈椎管狭窄症的准确诊断和治疗选择有指导意义．     

无骨折脱位型颈髓损伤的MRI分析

目的 :探讨无骨折脱位型颈髓损伤的发生机理、好发部位及MRI特点。材料和方法 :回顾性分析 43例无骨折脱位型颈髓损伤的MRI表现。结果 :共发现脊髓异常MR信号 46处 ,多位于C4-6水平 ,异常信号T1WI为低信号、等信号或高信号 ;T2WI为信号均匀或不均匀的高信号。结论 :MRI能显示脊髓损伤的范围和病理改变 ,明确脊髓损伤处有无突出椎间盘的持续性压迫。是无骨折脱位型颈髓损伤最好的检查方法     

Hirayama flexion myelopathy: neutral-position MR imaging findings--importance of loss of attachment

PURPOSE: To investigate the sensitivity and specificity of various neutral-position magnetic resonance (MR) imaging findings in the diagnosis of Hirayama flexion myelopathy. MATERIALS AND METHODS: The neutral-position cervical MR images of 46 patients and 51 control subjects were evaluated for the following findings: localized lower cervical cord atrophy, asymmetric cord flattening, abnormal cervical curvature, loss of attachment (LOA) between the posterior dural sac and subjacent lamina, and noncompressed intramedullary high signal intensity on T2-weighted MR images. The difference in frequency of these findings between the control and patient groups was examined by means of the chi(2) test. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of these MR imaging findings in the diagnosis Hirayama disease were calculated. Multivariate analysis of these findings was also performed. RESULTS: There was a significant difference in the frequency of these MR imaging findings between the control and patient groups (all comparisons, P 相似文献   

脊髓前动脉损伤致脊髓缺血性损伤模型的MRI评价

目的：研究经脊髓前动脉损伤，致脊髓缺血性损伤模型的高场强MRI信号表现特征。方法：选用12只家犬经颈前手术入路，切断脊髓前动脉，经高场强MRI扫描，对照病理分析脊髓前动脉损伤后脊髓的MRI信号变化特征。结果：脊髓前动脉损伤后脊髓MRI表现出异常T2WI高信号，且出现在脊髓前动脉损伤节段的前2／3，多表现为一例受累及或偏向一例。结论：MRI能确定脊髓缺血性损伤的部位及信号特征。     

平山病的MRI诊断价值

目的:探讨平山病的MR表现和价值,认识平山病的临床特征和可能的发病机制.方法:5例经临床确诊的平山病患者均隐匿起病,病变局限于上肢远端肌肉,4例单侧上肢前臂受累,1例双侧不对称性受累.5例患者均行颈椎X线平片检查,及颈髓常规自然体位MR平扫及屈颈位平扫 增强扫描.所有患者均进行常规生化检查,脑脊液检查,肌电图检查和肌肉活检.结果:5例患者普通X线检查4例可见颈椎生理曲度变直,自然体位MR平扫3例有低位脊髓萎缩变扁(萎缩水平在颈5-胸1,最明显在颈6水平),2例萎缩的脊髓内信号异常.曲颈MR检查时,除了可见自然体位MR的表现外,5例患者均可见特征性的颈髓前移、变平,硬脊膜向前移位,硬脊膜外腔增宽,4例患者在增宽的硬膜外腔均可见流空血管信号,增强扫描5例患者在增宽的硬脊膜外腔均可见强化的静脉丛.结论:平山病的MR表现存在一定的特征性,MR屈曲位平扫 增强扫描对平山病的诊断及其发病机制的理解有重要的价值.     

Magnetic resonance imaging of soft tissue tumors.

The value of magnetic resonance imaging (MRI) in histological classification was studied in a series of 164 histologically proven soft tissue tumors (STT) and was rather limited. MRI was only valuable in characterization of lipomatous, vascular and fibrous tumors. There are two main reasons for this limitation i.e. STT belonging to the same histological group may have different composition or different proportions in tumor components resulting in different MRI signals. Secondly tumor components may change individually or proportionally during natural evolution or as a consequence of therapy. Because well known grading parameters such as cellularity, mitotic rate, matrix and presence of necrosis all influence MRI signal intensity, the value of MRI in predicting malignancy is potentially high. To assess this value we retrospectively studied the findings in the first 141 soft tissue tumors (84 benign, 57 malignant) and evaluated a wide variety of MRI features (size, margins, signal homogeneity, shape, signal intensity, neurovascular and bone involvement, degree and pattern of enhancement and evidence of necrosis after injection of Gd-DTPA). Statistical analysis was carried out to determine accuracy of parameters individually and in combination, for predicting malignancy. Highest sensitivity was obtained for "absence of low signal intensity on T2" (100%), "mean diameter > 33 mm" (90%) and "inhomogeneous signal on T1" (88%). Highest specificity was obtained for "evidence of necrosis" (98%), "bone or neurovascular involvement or metastases" (94%) and "mean diameter > 66 mm" (87%). Association of best sensitivity (81%) and specificity (81%) was seen for "absence of low signal intensity on T2", "signal inhomogeneity on T1" and "mean diameter of the lesion > 33 mm". In a prospective study of 23 consecutive patients we reevaluated sensitivity and specificity in predicting malignancy of all parameters. Excellent correlation with the results of the retrospective study was found. Although a quantitative approach to the staging potentials of MRI was not possible, well known staging parameters are evaluated to the best by this method (size, depth, compartmental versus extra-compartmental location, relationship to adjacent structures).     

脊髓型颈椎病的MRI改变及其临床意义

目的探讨脊髓型颈椎病的MRI改变及其临床意义。方法回顾分析经手术和临床证实的脊髓型颈椎病23例的MRI改变。结果在全部患者的MRI上主要影像学改变为椎间隙变窄、椎间盘信号减弱、受累节段椎体后缘有信号减弱的致压物,受压颈髓弯曲、变形、向后移位等异常信号。结论MRI对脊髓型颈椎病的诊断、治疗方法选择和预后判断有重要价值。     

MRI in presumed cervical anterior spinal artery territory infarcts

WE report the MRI findings in two patients with presumed cervical spinal cord infarcts in the anterior spinal artery territory. MRI revealed abnormal signal intensities and/or band-like enhancement in the anterior two-thirds of the cervical spinal cord, corresponding to the vascular territory of the anterior spinal artery. Clinically there was an anterior spinal cord syndrome.