探讨磁共振扩散张量成像(DTI)在急性隐匿性颈髓损伤(CSCI)中的诊断价值。

选取2016年6月至2017年7月在九江市中医医院骨伤科及神经外科就诊，72 h内有明确外伤史，临床诊断为CSCI而常规磁共振(MR)序列显示脊髓无异常信号(隐匿性脊髓损伤)患者30例(损伤组)及30例健康志愿者(对照组)分别接受常规MR序列、DTI序列检查。对两组的DTI进行数据处理与分析，获得扩散张量纤维束成像(DTT)。分别测量损伤组和对照组的各向异性分数(FA)值和表观扩散系数(ADC)值，采用两独立样本t检验比较两组间差异。

损伤组的FA值(0.53±0.22)明显低于对照组FA值(0.65±0.12)，差异具有统计学意义(t＝5.00，P<0.01)。损伤组的ADC值[(1.15±0.28)×10^－3mm²/s]明显高于对照组ADC值[(1.04±0.57)×10^－3mm²/s]，差异具有统计学意义(t＝11.20，P<0.01)。损伤组颈髓DTT图示受损区域的白质纤维束稀疏、扭曲及断裂。

DTI的FA值和ADC值可定量分析CSCI患者脊髓白质损伤的严重程度，DTT图可准确描绘脊髓白质损伤的位置及范围，是目前无创性诊断隐匿性颈髓损伤和评估预后的一个重要手段。

To investigate the value of magnetic resonance diffusion tensor imaging (DTI) in the diagnosis of acute occult cervical spinal cord injury(CSCI).

Subjects were selected from the patients who were treated in orthopedics and neurosurgery department in hospital from June 2016 to July 2017. All the subjects had a clear history of trauma within 72 hours, and a non apparent abnormality of T2WI sequence and STIR sequence examination. Thirty patients joined the injured group and the control group contained 30 healthy volunteers. Both of them accepted MR sequence and DTI sequence examination respectively. Data processing and analysis were performed on both groups of DTIs to obtain diffusion tensor tractography (DTT). The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the two groups were measured respectively. Independent samples t-test was used to compare the differences between the two groups.

The FA value of injured group (0.53±0.22) was significantly lower than that of control group (0.65 ± 0.12), the difference was statistically significant (t=5.00, P<0.01). The ADC value [(1.15±0.28)×10^-3mm²/s] in injury group was significantly higher than that in the control group [(1.04±0.57)×10^-3mm²/s], the difference was statistically significant (t=11.20, P<0.01). The DTT of the cervical spinal cord of injury group showed sparse, twisted and broken white matter in the damaged area.

The FA and ADC value of DTI can quantitatively analyze the severity of spinal cord white matter injury in CSCI patients. DTT can accurately depict the location and extent of white matter damage in the spinal cord. It is an important mean for noninvasive diagnosis of occult cervical spinal cord injury and prognosis evaluation.