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1、磁共振弥散张量成像对脊髓损伤的临床应用价值作者：陈蕾，刘国利，王大维，陈延杰【摘要】目的：探讨磁共振弥散张量成像(diffusiontensorimaging,DTI)对脊髓损伤的临床应用价值。方法：选择42例健康志愿者作为对照组和54例脊髓型颈椎病作为病例组进行颈椎常规磁共振成像(MRI)及DTI,分别测量各组表观弥散系数(apparentdiffusioncoefficient,ADC)、部分各项异性(fractionalanisotropy,FA)值,并显示其弥散张量纤维束(diffusiontensortracking,DTT)o结果：对照组的平均ADC值为(830.3
2、4±215.86)x106mm2/s,平均FA值为(536.03±40.00)x103。脊髓慢性损伤患者平均ADC值为(1107.60±47.55)x106mm2/s,较对照组升高,有统计学意义(P<0.01),平均FA值为(425.91±59.48)x103,较对照组下降，有统计学意义(P<0.01)o结论：DTI较常规MRI成像能更早显示脊髓的损伤，ADC值、FA值及DTT图是检测早期脊髓损伤微观结构的敏感指标。【关键词】磁共振;弥散张量成像;脊髓损伤Clinicalapplicationofmagneticresonancediffusiontensorima
3、gingforspinalcordinjurydiagnosisCHENLeil,LIUGuo112,WANGDawei2,CHENYanjie2(l.InterventionalRadiologyDepartment,LonggangCentralHospitalofShenzhen,Shenzhen518116;2.DepartmentofRadiology,ChangchunCommunicableDiseaseHospitai,Changchun130123,China)[ABSTRACT]Objective:Toinvestigatetheclinicalapplic
4、ationofmagneticresonance(MR)diffusiontensorimagingforspinalcordinjurydiagnosis.Methods:Conventionalcervicalmagneticresonanceimaging(MRI)scanningandMRdiffusiontensorimagingwereperformedon54patientswithcervicalspondyloticmyelopathyand42casesofhealthyvolunteersasahealthycontrolgroup.Apparentdif
5、fusioncoefficient(ADC)andfractionalanisotropy(FA)weremeasured,diffusiontensortracking(DTT)wasshowedineachgroup.Results:TheaverageADCvalueis(830.34±215.86)x106mm2/s,theaverageFAvalueis(536.03±40.00)x103incontrolgroup;incontrasttheaverageADCvalueis(1107.60±47.55)x106mm2/s,higherthanthecontrolg
6、roupwithstatisticalsignificantdifference(P<0.01),andtheaverageFAvalueis(425.91土59.48)x103,lowerthanthecontrolgroupwithstatisticalsignificantdifference(P<0.01).Conclusion:MRdiffusiontensorimagingcanshowtheinjuryinthespinalcordatearlierstage.ADCvalue,FAvalueandDTTaresensitiveindicatorsof
7、theearlydetectionofmicrostructureofspinalcordinjury.[KEYWORDS]MR;Diffusiontensorimaging;Spinalcordinjury脊髓损伤的发病率为(20~40)/I00万,早期检测脊髓损伤及其程度，了解轴突损伤再生及再髓鞘化过程，对于脊髓损伤治疗及预后具有重要意义。常规磁共振成像(MRI)检查结果低估了脊髓损伤的程度[1],不能准确评估脊髓的功能状态。目前有关脊髓评价和治疗效果验证主要依靠临床的主观评价，其评价缺
