多节段脊髓型颈椎病髓内MRI T<sub>2</sub>WI高信号强度比值分级与预后相关性分析

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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.

Key words： multilevel cervicalspondyloticmyelopathy abnormalspinal cord signal classification prognosis

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	Liang Shuo
	Guan Haishan *

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Liang Shuo,Guan Haishan *. Analysis of Correlation between Classification of High Signal Intensity Ratio of Intramedullary MRI T2WI and Prognosis in Multilevel Cervical Spondyloticmyelopathy[J]. sygkzz, 2019, 25(7): 588-591.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2019/V25/I7/588

［1］袁文.多节段颈椎退变性疾病手术治疗中应思考的几个问题［J］.中国脊柱脊髓杂志，2010，23(3)：177-179.
［2］Fernandez de Rota JJ，Meschian S，Fernandez de Rota A，et al.Cervical spondylotic myelopathy due to chronic compression：the role of signal intensity changes in magnetic resonance images［J］.J Neurosurg Spine，2007，6(9)：17-22.
［3］李增春，陈德玉，吴德升，等.第三届全国颈椎病专题座谈会纪要［J］.中华外科杂志，2008，46(23)：1796-1799.
［4］张蜀华.MRI(核磁共振)和CT在脊柱脊髓损伤中的应用［J］.实用骨科杂志，1995，1(3)：167-169.
［5］Uchida K，Nakajima H，Takeura N，et al.Prognostic value ofchanges in spinal cord signal intensity on magnetic resonanceimaging in patients with cervical compressive myelopathy ［J］.Spine J，2014，14(8)：1601-1610.
［6］Mastronardi L，Elsawaf A，Roperto R，et al.Prognostic relevance of the postoperative evolution of intramedullary spinal cord changesin signal intensity on magnetic resonance imaging after anterior decompression for cervical spondylotic myelopathy［J］.J Neuro Surg Spine，2007，7(6)：615-622.
［7］Yagi M，Ninomiya K，Kihara M，et al.Long-term surgical outcomeand risk factors in patients with cervical myelopathy and a changein signal intensity of intramedullary spinal cord on Magnetic Reso-nance imaging［J］.J Neurosurg Spine，2010，12(1)：59-65.
［8］Kwon SY，Shin JJ，Lee JH，et al.Prognostic factors for surgical outcome in spinal cord injury associated-with ossification of the posterior longitudinal ligament(OPLL)［J］.J Orthop Surg Res，2015，10(1)：94.
［9］Ariga K，Miyamoto S，Nakase T，et al.The relationship between apoptosis of endplate chondrocytes and aging and degeneration of the intervertebral disc［J］.Spine，2001，26(22)：2414-2420.
［10］Suri A，Chabbra RP，Mehta VS，et al.Effect of intramedullary signal changes on the surgical outcome of patients with cervical spondylotic myelopathy［J］.Spine J，2003，3(6)：33-45.
［11］Okada Y，Ikata T，Yamada H，et al.Magnetic resonance imaging study on the results of surgery for cervical compression myelopathy［J］.Spine J，1993，18(5)：2024-2029.
［12］Matsuda Y，Miyazaki K，Tada K，et al.Increased MR signal intensity due to cervical myelopathy.Analysis of 29 surgical cases［J］.J Neurosurg，1991，74(4)：887-892.
［13］李凤宁，陈智，张帆，等.脊髓型颈椎 MRI T2WI 高信号与患者手术预后关系的 Meta 分析［J］.中国脊柱脊髓杂志，2011，21(1)：83-84.
［14］Bommireddy R，Kamat A，Smith ET，et al.Magnetic resonance image findings in the early post-operative period after anterior cervical discectomy［J］.Eur Spine J，2007，16(1)：27-31.
［15］Yukawa Y，Kato F，Yoshihara H，et al.MR T2 image classification in cervical compression myelopathy：predictor of surgical outcomes ［J］.Spine，2007，32(15)：1675-1678.
［16］柳万国，孙莉，唐成林，等.脊髓型颈椎病脊髓受压征象的MRI分级及其临床意义［J］.中国脊柱脊髓杂志，2012，22(6)：541-547.
［17］Chatley A，Kumar R，Jain VK，et al.Effect of spinal cord signal intensity changeson clinical outcome after surgery for cervical spondyloticmyelopathy［J］.J Neurosurg Spine，2009，11(10)：562-567.
［18］Zhang P，ShenY，ZhangY，et al.Significance of increased signal intensity on MRI in prognosis after surgical intervention for cervical spondylotic myelopathy［J］.J Clin Neurosci，2011，18(8)：1080-1083.
［19］Zhang JT，Meng FT，Wang S，et al.Predictors of surgical outcome in cervical spondylotic myelopathy：focusing on the quantitative signal intensity［J］.Eur Spine J，2015，24(12)：2941-2945.
［20］Tani T，Ushida T，Ishida K，et al.Relative safety of anteriormicrosurgical decompression versus laminoplasty for cervicalmyelopathy with a massive ossified posterior longitudinal ligament［J］.Spine，27(2)：2491-2498.