Analysis Of The Relationship Of MRI Imaging Morphological Changes With The Clinical Evaluation Of Cervical Myelopathy Patients

Objective: To explore the correlation and relationship of MRIimaging morphological changes of cervical spinal cord with cervicalmyelopathy clinical evaluation, measure cervical spinal cordcross-sectional shape (diameter, sagittal diameter, cross-sectional area),through the MRI of cervical spinal cord in patients.Methods: Retrospectively analyze102normal adults without spinalcord compression in cangzhou centeral hospital,59males and43females,aged from17to74years old, mean aged41.2years old. From February2012to October2013,41patients with cervical myelopathy treated in ourhospital were randomly collected,21males and14females, involved atotal number of106segments, single segment involved in six cases,double segments in14cases,21cases more than three segments, JOAscore from8.5to17points, an average of12.2points, anterior cervicalsurgery in27cases, posterior cervical surgery in9cases, four casestreated with anterior and posterior cervical surgery, one case treatedconservatively. Cervical myelopathy diagnostic criteria for the specialmeeting of China’s second session of cervical disease determined criteria,except for myelitis, spinal occupying, central brain disease, secondary-adhesive arachnoiditis, peripheral neuritis and other diseases. The studywas divided into two steps, one measure of the cross-sectional shapevalues on cervical MRI-T2of normal adults without spinal cordcompression, like C2.3.C3.4.C4.5.C5.6.C6.7. Under normal physicalcircumstance, The segment of C2、3was fewly oppressed, this studysuggested that spinal morphology of C2.3was relatively unchanged, toestimate the morphology of C3.4.C4.5.C5.6.C6.7, to explore the correlation of MRI imaging morphological changes of cervical spinal cord,C3.4.C4.5.C5.6.C6.7with C2.3.The second step was to measure cervical spinalcord axial morphological changes on MRI-T2of C2.3of cervicalmyelopathy patients and the cross-sectional shape values of spinalprimary responsibility segments, to estimate the spinal cord cross sectionsmorphology，the primary responsibility segment unpressurized sectionmorphology，to value the rate of the spinal cord C3.4.C4.5.C5.6.C6.7withC2.3.By the function of “Logistic” in Spss17.0, To explore the correlationand relationship of MRI imaging morphological changes of cervicalspinal cord with JOA score correlation. in patients with cervicalmyelopathy derived morphological changes in the spinal cord and the rateof patients in this study, MRI instrument (United States GE)3.0T, put thespinal cord MRI-T2cross-sectional axial images into the computer, tomeasure the cross-sectional shape of the spinal cord with photoshop8CS2software. This study defined the cross-sectional diameter and sagittaldiameter of the spinal cord as the diameter of the spinal cord, spinal shapechanged ratio=|the cross-sectional shape of spinal cord uncompressedprimarily of responsibility segment-the cross-sectional shape of spinalcord compressed of responsibility segment|/the cross-sectional shape ofspinal cord uncompressed primarily of responsibility segment.Results: The normal group of cervical spinal cord cross-sectionalshape of C2.3.C3.4.C4.5.C5.6.C6.7: diameter (mm), sagittal diameter (mm),cross-sectional area(mm2) were dividedly:10.40±0.63.6.63±1.27.57.22±7.67；11.10±0.90.6.38±0.61.60.21±8.25；11.40±0.83.6.33±0.62.62.21±8.83；10.90±1.76.6.02±0.60.58.99±7.66；10.20±0.89.5.46±0.67.48.84±7.85. The ratio of cervical spinal cordcross-sectional shape (diameter, sagittal diameter, cross-sectional area)corresponding to normal group C3.4.C4.5.C5.6.C6.7with ones of theC2.3.weredividedly:1.060,0.962,1.052;1.098,0.954,1.087;1.051,0.908,1.031;0.980,0.823,0.850.The ratio of cervical spinal cord cross-sectionalshape(diameter, sagittal diameter, diameter+sagittal diameter cross-sectional area) change was dividedly21.60±22.60%,29.40±21.06%,24.64±18.55%,23.21±14.03%.Patients with cervical spinal cordcross-sectional diameter of the spinal cord change rate with JOA scorewas no significant correlation (R=0.203, P>0.05); sagittal diameterchange rate with JOA score was no significant correlation (R=0.289, P>0.05); diameter and sagittal diameter change ratio with JOA score wasno significant correlation (R=0.295, P>0.05); the ratio of cross-sectionalarea with JOA score was significantly correlated (R=0.796,P<0.05).Conclusions: For patients with cervical myelopathy,Cervical spinalMRI diameter change ratio was no significant between the severity of theclinical seymptoms of cervical myelopathy;Cervical spinal MRIcross-sectional area change ratio was significantly correlated with theseverity of the clinical seymptoms of cervical myelopathy;Because ofthe creep deformation of cervical spinal cord generated aftercompression,so don,t simply assess severity of clinicl asymptoms ofcervical myelopathy patients with the diameter of the spinal cord change.