摘要:目的:探討平山病的MRI影像特點及其臨床應(yīng)用價值。方法:5例臨床確診平山病病例組和10例正常對照組進行頸椎自然位及屈頸位MRI檢查,矢狀位T1WI、T2WI及軸位T2WI,觀察頸髓、蛛網(wǎng)膜下腔及硬膜外腔變化情況。結(jié)果:病例組的5例平山病均系16~20歲男性。自然位:5例下位頸髓均萎縮變扁,硬膜外間隙未顯示增寬。屈頸位:5例C5~7頸髓前移變扁中,將變扁頸髓又分為上中下三段,以中段最窄,上下段漸移行至正常;C5~7蛛網(wǎng)膜下腔亦變窄,硬脊膜伴隨前移;而C4~7硬脊膜后間隙則增寬,呈新月形影,增寬程度分為輕、中、重三度,最重者位于C6椎體平面,T2加權(quán)像及T1WI增強呈高信號,其中1例內(nèi)見血管流空信號影。對照組為10例志愿者,自然位: 4例C3~7頸髓形態(tài)、大小基本一致,6例頸髓自頸3逐漸移行與胸1脊髓其大小一致;屈頸位:頸髓和蛛網(wǎng)膜下腔大小與自然位比較無明顯變化,硬膜后間隙自C3平面向下延至T1平面,T2WI上呈均勻線樣高信號影。結(jié)論:下位頸髓萎縮變扁,屈頸位頸髓及硬脊膜前移、硬脊膜后間隙增寬呈新月形影等,是臨床診斷平山病較特征性的MRI表現(xiàn)。Abstract: Objective: To evaluate clinical value and MRI features of Hirayama disease. Methods: Five cases of hirayama disease, which had been clinically confirmed using siemens sonata 1.5T MRI scan, physiological condition and flexional condition, Sagittal view T1WI, T2WI and Axial View T2WI, and GdDTPA enhanced examination, for MRI changes of spinal cord, subarachnoid cavity, duramater of spinal membrae and extra dural space, etc were studied. Results: In case group of 5 cases of hirayama disease, age was mainly in 16–20 years old, All of 5 cases were men. Which were pressed and become thinner of spinal cord, strictic changes of subarachnoid cavity, new moony shape and enlargement changes and pushed forward of extra duramater space, and higher intensity signal of GdDTPA enhancement, and vascular flow effect (one case ) in C5–C7. but also, for contrast group 10 cases of normal volunteer, physiological condition:4 cases in cervical spinal cord with shape and structure were uniformity, and duramater, subarachnoid cavity, extra duramater space etc in C3–C7 were abnormal. Six cases in cervical spinal cord with shape and structure gradully changed from C3 to T1; flexional condition: 10 cases of MRI changes of spinal cord, subarachnoid cavity were as same as it in physiological condition,all of T2 WI, higher intensity signal were homogeneous of extraduramater space in C3–T1. Conclusion: The feature findings of cervical spinal cord became thinner, and cervical cord, durameter pussed forward, new moony shape and enlargment of extradurameter space, vascular flow effusion, etc in MRI were useful value for clinical diagnosis.