| 摘要: |
| 脊髓型颈椎病（CSM）是老年人群中的常见疾病，由颈椎退变导致脊髓慢性受压所引起。磁共振成像（MRI）可显示椎管是否狭窄、脊髓受压的程度和信号的改变，但对脊髓轻度变性和微观结构的改变敏感性较低且不能定量分析。弥散张量成像（DTI）是一种可以评价神经纤维细胞内外水分子弥散特征的MRI新技术，评价参数包括表观弥散系数（ADC）和各向异性分数（FA），并可利用纤维束示踪成像（DTT）清晰地显示出神经纤维束的形态，是目前唯一可无创显示活体神经纤维束的方法。研究表明，DTI参数对CSM的早期诊断、神经功能评估和预后判断较常规MRI更加敏感，DTT可清晰显示脊髓纤维束形态和连续性的改变，也可准确评估神经功能并预测患者手术预后，但脊髓DTI成像仍有许多干扰因素，脊髓DTI参数如何测量和分析尚无统一标准，并且DTT能否完全反映脊髓真实病理状态，有待进一步研究。本文就脊髓DTI成像技术发展和DTI在CSM中的研究进展作一综述。 |
| 关键词: 脊髓型颈椎病 磁共振成像 弥散张量成像 表观弥散系数 各向异性分数 纤维束示踪成像 |
| DOI：10.3724/SP.J.1008.2014.00780 |
| 投稿时间：2014-03-24修订日期：2014-05-20 |
| 基金项目:第二军医大学长海医院“1255”计划基金（CH12550900） |
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| Application of diffusion tensor imaging in cervical spondylotic myelopathy：recent advance |
| WANG Kun1,HAO Qiang2,SHEN Hong-xing1* |
(1. Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.) |
| Abstract: |
| Cervical spondylotic myelopathy (CSM), commonly seen in the elderly, is caused by the chronic compression of the spinal cord induced by cervical disc degradation. Magnetic resonance imaging (MRI) can clearly reveal spinal canal stenosis, morphology and signal changes of compressed spinal cord, but it falls short in demonstrating the slight changes and microstructure of the spinal cord and is not capable of quantitative analysis. Diffusion tensor imaging (DTI) is a new MRI technique which can display the water molecule diffusion characteristics in the nerve fiber cells, with the evaluation parameters mainly including the apparent diffusion coefficient (ADC) and the fractional anisotropy (FA). Moreover, it can clearly display the fiber bundle of the spinal cord with the diffusion tensor tractography (DTT), making it currently the only non-invasive way to trace the white matter fiber bundle. Studies have reported that DTI parameters compared with routine MRI is more sensitive in early diagnosis, neuronal function evaluation, and prognosis prediction of CSM. DTT can clearly display the morphology and dynamic changes of spinal nerve bundles, evaluate the neuronal function and predict the post-operation prognosis. There are still limitations for spinal DTI, such as lack of standard method for measuring and analyzing DTI parameters, and whether DTT can reflect the true pathological status of spinal cord. Here we reviewed the development of DTI technology and its role in CSM. |
| Key words: cervical spondylotic myelopathy magnetic resonance imaging diffusion tensor imaging apparent diffusion coefficient fractional anisotropy tractography |
