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目的使用3.0 T磁共振扩散张量成像(DTI)技术观察创伤性颈髓损伤(SCI)患者颈髓白质纤维束的改变,探讨DTI对SCI的早期诊断价值及其预后演变规律。方法选取经临床诊断为SCI的患者34例(损伤组)及20名健康对照者(对照组)分别进行常规MRI及DTI检查;损伤组分为A,B组,A组为T_2WI序列显示颈髓内高信号16例,B组为T_2WI序列显示无明显异常信号18例;分别测量A、B组(急性期、亚急性期、伤后5周~3个月)和对照组各向异性分数(FA)值、表观扩散系数(ADC)值,行统计学分析。结果与正常对照组相比,A、B组FA值减低,以后呈逐渐升高趋势,但均低于对照组,差异有统计学意义(P均<0.001);A组ADC值增高,以后呈逐渐减低趋势,但均高于对照组,差异有统计学意义(P均<0.001),B组ADC值在急性期增高(P<0.001),以后逐渐与对照组趋于一致,差异无统计学意义(P均>0.05)。结论DTI及DTT能够显示T_2WI序列上阴性的早期SCI;FA值能够预测SCI的预后情况。
Objective To observe the changes of cervical white matter fiber bundles in patients with traumatic cervical spinal cord injury (SCI) by using 3.0 T magnetic resonance diffusion tensor imaging (DTI) technique and to explore the early diagnostic value and prognosis of DTI. Methods Thirty-four patients (injury group) and 20 healthy controls (control group) were selected for routine MRI and DTI examinations respectively. The injury components were group A and B, and the group A was T 2 WI 16 cases of intraepithelial high signal and 18 cases of non-obvious abnormal signal of T_2WI in group B. The anisotropy scores of group A and B (acute phase, subacute phase, 5 weeks to 3 months after injury) and the control group FA) value, apparent diffusion coefficient (ADC) values, line statistical analysis. Results Compared with the normal control group, the FA values in A and B groups decreased gradually and gradually increased afterwards, but both were lower than those in control group (P <0.001). ADC value in A group was increased (P <0.001). The ADC value of group B was increased in acute phase (P <0.001), and then gradually aggravated with that in control group, and the difference was not statistically significant Significance (P> 0.05). Conclusions DTI and DTT can display the negative early SCI of T_2WI sequence. FA value can predict the prognosis of SCI.