文章摘要
于学涛,热迪娜 ·亚生,谢荣.磁共振弥散张量成像、 mJOA评分对多节段脊髓型颈椎病临床评估及其与血清免疫球蛋白含量相关性研究[J].安徽医药,2022,26(1):40-44.
磁共振弥散张量成像、 mJOA评分对多节段脊髓型颈椎病临床评估及其与血清免疫球蛋白含量相关性研究
Study on diffusion tensor imaging and mJOA score in clinical evaluation of multilevel cervical spondylotic myelopathy and their correlation with serum immunoglobuin content
  
DOI:10.3969/j.issn.1009-6469.2022.01.009
中文关键词: 椎间盘退行性变  颈椎  脊髓损伤  多节段型脊髓型颈椎病  磁共振弥散张量成像  mJOA评分  血清免疫球蛋白
英文关键词: Intervertebral disc degeneration  Cervical vertebrae  Spinal cord injuries  Multilevel cervical spondylotic myelopa-thy  Diffusion tensor imaging  mJOA score  Serum immunoglobuin
基金项目:新疆维吾尔自治区人民医院科技引进创新项目( 20180318)
作者单位E-mail
于学涛 新疆维吾尔自治区人民医院康复科新疆维吾尔自治区乌鲁木齐 830001  
热迪娜 ·亚生 新疆维吾尔自治区人民医院康复科新疆维吾尔自治区乌鲁木齐 830001  
谢荣 新疆维吾尔自治区人民医院康复科新疆维吾尔自治区乌鲁木齐 830001 r8569362@126.com 
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中文摘要:
      目的探讨磁共振弥散张量成像与血清学免疫血检查在常规磁共振未检出异常信号前预测 MCSM病情中的价值。方法选择 2019年 1—12月期间入住新疆维吾尔自治区人民医院保守治疗 /手术治疗的 50例 MCSM病人作为病例组;纳入同期在医院磁共振室接受颈椎常规核磁共振检查的健康体检者 50例作为对照组。全部纳入者均接受磁共振弥散张量成像与 mJOA评分评级与血清免疫球蛋白(Ig)含量检测;首先比较对照组不同节段影像学主要参数[向异性( FA)、弥散系数(ADC)、最大脊髓压迫( MSCC)]观察病例组 T2信号异常检出情况,比较各组各影像学参数值与 mJOA评分;检验 FA值、 ADC值、 mJOA评分与 MSCC值的相关性,。结果对照组各节段 FA、ADC值比较,均差异无统计学意义( P>0.05);对照组、 T2信号正常组、 T2信号异常组 FA值分别为( 0.61±0.05)、(0.48±0.04)(0.40±0.06)其中对照组 FA值最高;对照组、 T2信号正常组、 T2信号异常组 ADC值分别为( 1.13±0.13)、(1.37±0.12)(1.46±0.15)、其中对照组,ADC值最低;对照组、 T2信号正常组、 T2信号异常组 mJOA评分分别为( 15.02±1.17)分、(13.11±1.45)分、(、10.14±2.51),分,其中对照组 mJOA评分最高,差异有统计学意义( P<0.05);较对照组,病例组整体免疫球蛋白 G(IgG)含量升高( P<0.05)且 T2信号异常组明显高于信号正常组( P<0.05);三组免疫球蛋白 A(IgA)、免疫球蛋白 M(IgM)、 C3含量比较,差异无统计学意,义( P>0.05);中重度组 T2信号正常组、异常组病人 IgG含量高于轻度组( P<0.05),组间 IgA、IgM、C3含量比较,差异无统计学意义( P>0.05)。结论经磁共振弥散张量成像与血清 IgG检查,有助
英文摘要:
      Objective To compare the serum immunoglobulin content of patients with different functional grades, and to investigatethe value of diffusion tensor imaging and immunological examination in predicting the conditions of MCSM before abnormal signals aredetected by conventional magnetic resonance imaging.Methods Fifty MCSM patients with conservative treatment or surgical treat-ment in the People's Hospital of Xinjiang Uygur Autonomous Region from January to December 2019 were selected as the case group,while 50 healthy volunteers who underwent routine cervical magnetic resonance imaging in the magnetic resonance room of the Peo-ple's Hospital of the Autonomous Region during the same period were included in the control group. All enrolled patients received dif-fusion tensor imaging, mJOA score classification, and serum immunoglobulin (Ig) content detection. The main imaging parameters [frac-tional anisotropy (FA), apparent diffusion coefficient (ADC), maximum spinal cord compression (MSCC)] of different segments in thecontrol group were compared, the abnormal detection of T2 signal in the case group was observed, and the value of each imaging param-eter and mJOA score in each group were compared. The correlation between FA value, ADC value, mJOA score and MSCC value wasdetected. The serum Ig content in normal group, abnormal T2 signal group and normal signal group was compared.Results There was no statistical significant difference in the FA and ADC values of different segments in the control groups (P>0.05). The FA values of con-trol group, normal T2 signal group and abnormal T2 signal group were (0.61±0.05), (0.48±0.04) and (0.40±0.06), respectively, of whichthe FA value of control group was the highest. The ADC values of control group, normal T2 signal group and abnormal T2 signal group were (1.13±0.13), (1.37±0.12) and (1.46±0.15), respectively, of which the ADC value of control group was the lowest. The mJOA scoresof control group, normal T2 signal group and abnormal T2 signal group were (15.02±1.17), (13.11±1.45) and (10.14±2.51), respectively,of which the mJOA score of control group was the highest, the difference was statistically significant (P<0.05). Compared with the control group, the overall IgG content in the case group was increased (P<0.05), and that in abnormal T2 signal group was significantly higher than normal signal group (P<0.05). There was no statistical significant difference in the IgA, IgM and C3 contents among the three groups (P>0.05). The IgG content of patients in moderate-severe group, normal T2 signal group and abnormal group was higher than mild group (P<0.05), and there was no statistical difference in the IgA, IgM and C3 contents between groups (P>0.05).Conclusion Diffusion tensor imaging and serum IgG examination can help the clinic to understand the early micro lesions of the patients' spinal cord earlierwhen abnormal signals cannot be detected by conventional magnetic resonance imaging, which provides quantitative basis of imagingand immunology for clinical development of therapeutic regimen.
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