| Objective: To analysis (1)the relationship of MRIT2 signal intensity ratio of cervical cord with duration of disease, age, and severity of clinical symptoms(evaluate by Japanese Orthopedic Association score, JOA score); (2)the relationship of the number of compressed segments with MRIT2 signal intensity ratio, duration of disease, age, and severity of clinical symptoms(JOA score) in patients with cervical spondylotic myelopathy (CSM) by measuring MRIT2 high/normal signal intensity, range of the high/normal signal area of cervical cord. Then the signal intensity ratio was calculated and quantitative classification was made by the ratio. At the same time, evaluate the severity of clinical symptoms by JOA score. At last, we want to provide evidence for further study of the clinical value of MRIT2 high signal intensity, scope and the number of damage segments in patients with CSM.Methods: The patients with CSM who admitted to the Third Hospital of Hebei Medical University from Aug.2010 to Mar.2011 were chose. All patients underwent high-resolution 1.5T MRI in the department of MRI. The signal intensity was obtained from T2-weighted images (T2WI) of the sagittal signal on the cervical severe compression cord, and the regions of interest (ROIs) were taken by 0.05cm2. T2-weighted MR images of sagittal normal cord signal on the cervical between C7-T1 disc levels were obtained, and the ROIs were taken by 0.3cm2. Signal value was measured by computer and the signal ratio between the regions of the 0.05cm2 and 0.3cm2 was calculated. If no intramedullary high signal intensity was noted on T2-weighted MR images, the ROIs were taken by 0.05 cm2 of the severe compression cord . Damaged segments were also recorded and the calculation of the segment was made by cord compression. The standard of cord compression was that when the high signal between dura mater and spinal cord on T2-weighted images (T2WI) of the sagittal signal was disappeared. Groups of study subjects (1) all subjects were divided into 3 groups by signal intensity ratio with K-means cluster methods: low, medium and high signal ratio groups. (2) All subjects were divided into 2 groups by the number of compressed segments: single-segment groups and multi-segment groups. The basic information were recorded at the same time, including gender, age and duration of disease, and the function of spinal cord were evaluated by JOA score system. The relationships of signal intensity ratio with gender, age, duration of disease and JOA scores were analyzed. And the relationships of damaged segments with gender, age, duration of disease, JOA scores and signal intensity ratio were also analyzed.Results: During the study period, a total of 50 patients were enrolled in this study, including 27males and 23 female. The range of age was from 33 to 78 years old with an average of 53.06. The duration of disease was from 0.5 months to 4 years with an average of 9.45 months. There were 20 cases that were single segment damaged and 30 cases that were multiple segments(including two segments and above) damaged.①All subjects were divided into 3 groups by MRIT2WI signal intensity ratio with K-means cluster methods, including 21 cases of low signal ratio group, 15 cases of medium signal ratio group and 14 cases of high signal ratio groups. The average signal intensity ratio of each group were 1.138±0.078, 1.425±0.070,1.804±0.090.②Divided all the subjects according to the number of damaged segments: including 30 cases of single-segments and 20 cases of multi-segments. The gender and age of the different signal intensity ratio groups had no statistically significant (P>0.05); but the duration of disease and JOA scores of different groups had statistically significant(F=6.905, P=0.032 ; F=12.491, P=0.002). Further pairwise comparisons of the duration of disease and JOA scores showed that the duration of disease were statistically different between the low signal intensity ratio group and medium signal intensity ratio group(P=0.09), but there had no differences between the low signal intensity ratio group and medium signal intensity ratio group, and also medium signal intensity ratio group and medium signal intensity ratio group(P=0.133, P=0.288). JOA scores between low signal intensity ratio group and high signal intensity ratio group had statistically differences, and also the medium signal intensity ratio group and high signal intensity ratio group(P=0.000, P=0.025).While there had no significant differences between the low signal intensity ratio group and medium signal intensity ratio group(P=0.131).The composition of gender and signal intensity ratio had no statistically differences of different damaged segments(P>0.05).The duration of disease of the two groups also had statistically differences(t=3.906, P=0.000).There were statistically differences of the age and JOA scores(t=3.440, P=0.001; t=2.882, P=0.003).Conclusions: The patients with low signal intensity ratio and damaged single-segment often have short duration of disease and high JOA scores. Conversely, patients with high MRIT2WI signal and more damaged segments have long duration of disease and low JOA scores relatively. It means that the function of spinal cord will decreased with the increase of MRI signal intensity, the number of impaired segments and the duration of disease. It suggests that the CSM patients should diagnose and treat the disease as early as possible, especially for the patients who have high MRI signal intensity and more damaged segments.
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