摘要
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P<0.05)。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。
Objective To explore the clinical application value of conventional cervical spinal cord MRI and diffusion tensor imaging （DTI） in patients with optic neuromyelitis （NMO）. Methods Conventional and axial DTI of the cervical spinal cord were performed in 20 patients with NMO and 20 sex-and age-matched healthy controls. Fractional anisotropy （FA） and mean dif- fusivity （MD） were measured in the spinal cord at the C2 - C5 level. Regions of interest （ROIs） were p[aced in the anterior, lat- eral, posterior white matter of spinal cord and the central grey matter of spinal cord. Results The locations of spinal cord lesions in patients with NMO were merely in the cervical cord （20%）, or simply in the thoracic cord （5%）, or both （75%）. Compared with healthy controls, the values of FA were decreased in bilateral anterior, lateral, posterior cord, grey matter and MD were in- creased in bilateral lateral and posterior cord, gray matter in NMO group, there were significant differences among them （ P 〈 0. 05 ）. Conclusion Conventional cervical cord MRI is helpful to detect the lesion and confirm the position of it, DTI can detect the abnormal diffusion metrics changes quantitatively, provide important information for early clinical diagnosis.
出处
《医学影像学杂志》
2017年第1期29-32,共4页
Journal of Medical Imaging
基金
国家自然科学基金青年项目(编号:81401377)
"十二五"国家科技支撑计划课题(No.2012BAI10B04)
北京市医院管理局重点医学专业发展计划(编号:ZYLX201609)
关键词
视神经脊髓炎
磁共振成像
扩散张量成像
颈髓
Neuromyelitis optica
MRI
Diffusion tensor imaging
Cervical spinal cord
