基于磁共振弥散张量的脊髓型颈椎病诊断效能分析

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【中图分类号】 R445.2 【文献标志码】 A 【文章编号】1672-7770（2025）06-0655-07

Abstract： Objective To investigate the diagnostic efficacy of cervical spondylotic myelopathy （CSM）based on diffusion tensor imaging（DTI）.MethodsThe clinical data of 2O CSM patients who were admitted to Department of Neurosurgery， Second Afliated Hospital of Xinjiang Medical University from January 2O24 to December 2O24 were analyzed retrospectively. All patients underwent 3.O T cervical magnetic resonance imaging（MRI） and DTI scans. The Fractional Anisotropy（FA），Axial Diffusivity（AD），Mean Diffusivity（MD），and relative anisotropy（RA） from DTI were compared between the normal cervical segments（C1- C2， C2 - C3， C3 - C4）and lesion segments（C4 - C5，C5 - C6，C6 - C7）. Binary logit regression analysis and receiver operating characteristic（ROC） curve were used to evaluate the diagnostic eficacy of DTI for CSM lesions.ResultsNormality test revealed that AD values were not normally distributed（ P<0.05） ， while FA，MD，and RA values exhibited normality（ P>0.05， ）. Binary Logistic regression revealed that FA（regression coefficient =-0.005 ， z=-3，446 ， P=0.001 ），AD（regression coefficient -0.002 ， z=-2.017 ！ P=0.044 ），and RA（regression coefficient =-0.001 ， z=-3.867 ， P< 0.001）all had significant negative efects on group clasification. The area under the ROC curve （AUC）values of FA，AD，and RA for predicting CSM were 0.771，0. 748，and 0.746， respectively. ConclusionsFA，AD，and RA values of DTI have high sensitivity and specificity for diagnosing CSM， while the diagnostic eficacy of MD requires further research. DTI is predictive of disease prognosis，provides crucial information for preoperative evaluation of cervical surgical segments，and offersvaluable guidance for clinicians in formulating personalized treatment strategies.

Key words：magnetic resonance diffusion tensor imaging；cervical spondylotic myelopathy ; diagnostic efficacy

弥散张量成像（diffusion tensor imaging，DTI）是基于水分子扩散运动的先进磁共振成像（magneticresonance imaging，MRI）技术[1-2]，通过检测生物组织内水分子三维随机运动，定量评估组织微观结构完整性[3-4，并通过各向异性分数（fractionalanisotropy，FA）、平均弥散系数（meandiffusivity，MD）等量化参数提供客观影像学依据[5-6]，在神经系统疾病诊断、评估及监测中具有重要价值。（剩余13805字）