磁共振表观弥散系数在早期颈髓损伤诊断中的临床应用

摘要

目的：观察早期颈髓损伤后脊髓囊性变、患者运动功能改善情况与表观弥散系数(ADC)值的关系。方法对18例早期颈髓损伤患者进行磁共振T1WI、T2WI、弥散加权成像(DWI)检查，获得ADC值和ADC图，并通过康复评价获得治疗前后脊髓损伤神经学分类(ASIA)评分。分析ADC值与脊髓囊性变和患者运动功能改善的关系。结果早期颈髓损伤发生囊性变的ADC值低于未发生囊性变的ADC值，两者的分界点在700×10-6 mm2/s。患者年龄与ADC值呈正相关。康复运动功能改善与ADC值无明显相关性。结论早期颈髓损伤发生脊髓囊性变时ADC值多在700×10-6 mm2/s以下。目前为止，还不能通过测定ADC值来判断早期颈髓损伤患者的运动功能恢复情况。%Objective To observe the relationship between spinal cord cystic degeneration, spinal cord movement improvement and ap-parent diffusion coefficient (ADC) values after early cervical spinal cord injury. Methods 18 patients with early cervical spinal cord injury were examined with MRI T1WI, T2WI and diffusion weighted imaging (DWI). Then ADC values and ADC maps were obtained. Their ASIA motor scores were also recorded. The relationship between spinal cord cystic degeneration and spinal cord movement improvement and ADC values was analyzed. Results ADC values were lower in those with cystic degeneration than without cystic degeneration in early cervi-cal spinal cord injury, and the cut-off point was 700×10-6 mm2/s. ADC values were positively correlated with age. The movement improve-ment did not obviously correlate with ADC values. Conclusion ADC values of early cervical spinal cord injury are less than 700×10-6 mm2/s when cystic degeneration happened. Motor function recovery of patients with early cervical spinal cord injury cannot be estimated by mea-suring ADC values.