Analysis of Correlation between Classification of High Signal Intensity Ratio of Intramedullary MRI T2WI and Prognosis in Multilevel Cervical Spondyloticmyelopathy
Department of Orthopaedics,Second Hospital of Shanxi Medical University
Abstract:Objective To classify the quantitative signal change ratio(QSCR) ratio in cervical spinal cordof patients with multilevel cervical spondylotic myelopathy (MCSM) on magnetic resonance imaging (MRI T2WI) and to explore the correlation between the quantitative signal change ratio grading system in the spinal cord of cervical spine on MRI T2W1 and the clinical effect after decompression.Methods The clinical data of 50 patients with multilevel cervical spondylotic myelopathy accompanied by intramedullary high signal intensity changes on MRI T2WI were collected from January 2014 to December 2017.They were divided into <50% group (group A) and ≥50% group (group B) according to whether the improvement rate of nerve function was more than 50%.The high signal area of 0.1 cm2 and the normal intramedullary signal area of C7~T1 0.1 cm2 on the same sagittal plane were measured on cervical MRI T2WI,and the quantitative change rate of signal intensity was calculated.According to JOA score,the quantitative change rate of intramedullary signal intensity before operation was graded 4.Results All patients were followed up regularly for 6 to 24 months.There were no significant differences in sex ratio,age,course of disease,number of lesion segments,preoperative JOA score and follow-up time between the two groups (P>0.05).There were 25 patients in group A,with preoperative QSCR of (1.61+0.25);and 25 patients in group B,with preoperative QSCR of (1.30+0.18).Preoperative QSCR was negatively correlated with JOA score improvement rate (r=-0.876,P<0.001).The improvement rate of JOA score better than 75% is excellent in 6 cases;the improvement rate of JOA score was 50% to 74%,which was good in 19 cases;the improvement rate of JOA score was 25% to 49%,which was fair in 16 cases;The improvement rate of JOA score below 25% is poor,in 9 cases.The results of variance analysis showed that there was a significant difference in the quantitative signal change ratio among the four groups (P<0.01),and There were significant differences between the excellent group and the good group,between the good group and the fair group,between the fair group and the poor group(P<0.05).Conclusion Preoperative grading of intramedullary high signal in MCSM is of guiding significance for evaluating prognosis.Surgery before the quantitative change rate of signal intensity reaches a higher level can improve the curative effect of surgery.
梁硕,关海山 *. 多节段脊髓型颈椎病髓内MRI T2WI高信号强度比值分级与预后相关性分析[J]. 实用骨科杂志, 2019, 25(7): 588-591.
Liang Shuo,Guan Haishan *. Analysis of Correlation between Classification of High Signal Intensity Ratio of Intramedullary MRI T2WI and Prognosis in Multilevel Cervical Spondyloticmyelopathy. sygkzz, 2019, 25(7): 588-591.
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