天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (8): 954-957.doi: 10.11958/j.issn.0253-9896.2015.08.034

• 综述 • 上一篇    下一篇

颈脊髓MRI T2 高信号变化与脊髓型颈椎病预后的关系

官丙刚1，邓树才1，韩燕2   

  1. 1 天津市天津医院脊柱外科（邮编300211）；2 天津中医药研究院附属医院影像科
  • 收稿日期:2014-11-03 修回日期:2015-02-20 出版日期:2015-08-15 发布日期:2015-08-15
  • 通讯作者: 韩燕 E-mail:guanbinggang@163.com
  • 作者简介:官丙刚（1974），男，主治医师，医学博士，主要从事颈椎及腰椎退行性疾病的基础与临床研究

Correlation of hyperintensity T2-weighted magnetic resonance imaging and prognosis of cervical spondylotic myelopathy

GUAN Binggang1，DENG Shucai 1，HAN Yan2   

  1. 1 Department of Spine Surgery, Tianjin Hospital, Tianjin 300211, China; 2 Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital
  • Received:2014-11-03 Revised:2015-02-20 Published:2015-08-15 Online:2015-08-15

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摘要： 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。

关键词: 颈椎病, 预后, 脊髓型颈椎病, 髓内高信号, T2WI

Abstract: 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.

Key words: cervical spondylosis, prognosis, cervical spondylotic myelopathy, intramedullary hyperintensity, T2-weighted image