平山病患者的MRI影像学表现

摘要

目的：通过分析平山病患者MRI的影像学表现，总结其MRI的高发表现。方法：选取2006年6月-2013年5月本院门诊和病房确诊的平山病患者48例作为研究对象，所有患者均行颈椎屈曲位和中立位MRI检查（共38例患者完成中立位横断面扫描），并进行影像学分析。结果：所有患者均表现为屈曲位硬膜囊前移；79.2%（38/48）的患者屈曲位硬膜外血管曲张蔓延到胸椎；89.6%（43/48）可观察到屈曲位横断面脊髓楔形变；仅33.3%（16/48）可观察到硬膜外血管流空信号；除此之外，94.7%（36/38）表现为中立位横断面下颈椎硬膜囊和椎板分离；83.3%（40/48）表现为中立位下颈椎脊髓萎缩；64.6%（31/48）表现为中立位颈椎间盘退变；95.8%（46/48）表现为中立位颈椎曲度异常。结论：屈曲位颈椎MRI在诊断平山病上具有高度准确性，中立位颈椎MRI对于平山病诊断同样具有一定的指向作用。%Objective: To evaluate the MRI finding in Hirayama disease patients. Method:48 patients with Hirayama disease were selected from Jun 2006 to May 2013. The flexed and neutral position cervical MRI imaging features were evaluated and analyzed.Result:100% cases showed anterior shifting of the posterior wall of the cervical dural canal in cervical flexed MRI. 79.2% patients had thoracic extension of epidural varicose vessel. 89.6% (43/48) cases could found asymmetric cord flattening. But only 33.3% (16/48) cases revealed flow void signals. Additionally, in neutral position MRI, 94.7% cases (36/38) had LOA, 83.3% (40/48) patients had localized lower cervical atrophy, 64.6% (31/48) cases had cervical disc degeneration, 95.8% patients showed cervical curvature changed as well.Conclusion: Cervical flexed position MRI is an accurate method for the diagnosis of Hirayama disease. Cervical neutral position MRI also has direction effect for the diagnosis of Hirayama disease.