目的：探讨颈椎病不同中医分型的CT及MRI影像学表现，以指导临床诊治。方法纳入120例颈椎病患者，参考相关标准，将其划分为风寒湿型、痰湿阻络型、气滞血瘀型、肝肾不足型、气血亏虚型。均联合开展CT、MRI诊断，探讨不同分型的影像学表现差异。结果风寒湿型影像改变主要为颈椎生理曲度变化、钩锥关节增生及韧带钙化，首选检测方法为CT；痰湿阻络型多表现为椎管前后径狭窄、椎体前后缘骨质增生，首选检测方法为MRI；气滞血瘀型多表现为椎间孔狭窄、椎体及钩椎关节骨质增生，首选检测方法为MRI；肝肾不足型主要表现为横突孔狭窄、椎动脉扭曲狭窄等，首选检测方法为MRI；气血亏虚型多表现为椎体排列不稳，需合理结合临床表现确诊。结论CT及MRI影像有助于颈椎病的中医分型，对指导临床用要有一定价值，值得关注。%Objective To investigate the CT and MRI imaging features of different TCM syndrome in patients with cervical spondylosis to guide the clinical diagnosis and treatment.Methods 120 cases of patients with cervical spondylosis were divided into wind cold dampness, phlegm dampness type, qi stagnation and blood stasis and liver and kidney deficiency according to the relevant standards. Diagnosis of MRI and CT were carried out together and differences between different types of images were studied.ResultsThe changes of wind cold dampness type image mainly showed the changes of cervical physiological curvature and the uncovertebral joints hyperplasia and calcification of the ligament. The preferred detection method was CT. The phlegm dampness type showed the spinal canal stenosis. The preferred detection method was MRI. Qi stagnation and blood stasis type showed lumbar Foramen Stenosis and vertebral body and hook vertebral joint bone hyperplasia. The preferred detection method was MRI. The liver and kidney deficiency type mainly showed transverse foramen stenosis and twisted stenosis of vertebral artery. The preferred detection method was MRI. Qi and blood deficiency type showed vertebral instability, which needed to be diagnosed reasonably and clinically.Conclusion CT and MRI imaging is helpful for the TCM type of cervical spondylosis and has a certain value in guiding the clinical use, which is worth attention.
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