摘要
目的研究脊髓型颈椎病MRI影像学测量指标代偿间隙侵占率与术前JOA评分及术后改善率之间的关系,探讨其临床意义。
方法回顾分析62例进行手术的脊髓型颈椎病患者的临床资料,记录其一般资料及术前、术后JOA评分,术后改善率等。应用专业图像处理软件(Photoshop8.0.1)在MRI电子影像资料上测量并计算代偿间隙/椎管面积比值(A),突入椎管内间盘/椎管面积比值(B),脊髓/椎管面积比值(C)及代偿间隙侵占率(D)。对术前JOA评分中重度组(0~12分)和轻度组(13~17分)的代偿间隙侵占率进行比较,并统计分析影像学测量指标与术后改善率的相关性及相关程度。
结果术前JOA评分中重度组和轻度组两组病例的代偿间隙侵占率存在统计学差异(P<0.05),且中重度组的代偿间隙侵占率明显高于轻度组。测量指标与术后改善率回归分析结果:指标B,C,D的显著性水平分别为<0.01,0.052,0.056,标化偏回归系数分别为-0.613,-0.269,-0.259,表明这三个影像学指标与术后改善率之间关系较密切。其中测量指标D即代偿间隙侵占率对术后改善率影响最大。
结论代偿间隙侵占率有助于判断脊髓型颈椎病的严重程度。代偿间隙侵占率、间盘/功能性椎管面积比值、脊髓/功能性椎管面积比值三个影像学指标与术后改善率之间关系较为密切,其中代偿间隙侵占率与术后改善率的密切程度最高,可作为判断术后改善率的可行指标。
Objective:
To analyze the correlation of CSM patients differ in pre-operative JOA score and post-operative recovery rate with the MRI measurement indexes separatively. And discuss their clinical significance.
Method:
We retrospective analyzed 62 patients in whom CSM was diagnosed. And recorded the general data of patients, JOA score of pre-operation, JOA score of post-operation, clinical recovery rate etc. Measured and calculated the index-A, B, C and D by using the soft of Photoshop8.0.1 And then we analyzed the correlation of CSM patients differ in pre-operative JOA score and post-operative recovery rate with the MRI measurement indexes separatively by using the software of SPSS.
Results:
To analysis the differences of index-D between the two groups differd in JOA score of pre-operation by using the software of SPSS. It is found that P<0.05. And there was a correlation with Index-B, C, D and clinical recovery rate. The significance level of Index-D was 0.056. The regression coefficient was-0.259. The significance level of Index-C was 0.052, and the regression coefficient of Index-C was-0.269. The significance level of Index-B was less than 0.01, the regression coefficient of Index-B was-0.613.
Conclusion:
Our findings indicated that Index-D contributed to judge the serious level of CSM.There was a close correlation of index-D and clinical recovery rate.
引文
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