脊髓型颈椎病MRI、病理及临床分期相关性研究研究牛：马晓磊导师：陈建常副教授目的：了解颈椎间盘退变的MRI和病理变化特点及临床分期的相关性。方法:将手术治疗的23例脊髓型颈椎病（CSM）患者，共30个病变椎间盘的术前MRI表现在T2加权像上信号进行分析，测量病变椎间盘相对信号强度，结合Pfirrmann分级系统将病变椎间盘进行分级，术后病变椎间盘髓核行HE染色，观察病理变化并评价退变程度，分析MRI两种评价方式与组织病理学评估的一致性。将相对信号强度评估为中、重度退变椎间盘髓核进行组间比较。组织病理学评估为中、重度退变椎间盘髓核内存活软骨细胞数组间比较。对所选病例进行临床分期，并与MRI特点进行对比。结果：Pfirrmann分级系统、相对信号分级分别与组织病理学比较，Kappa值分别为0.613,0.742,一致性较高；Pfirrmann分级系统与临床分期平均符合率69.6%；相对信号强度分级椎间盘中、重度退变组间比较，匸4.374,0.05,有统计学意义。组织病理学评价为中、重度退变椎间盘髓核平均存活软骨样细胞数组间比较，=3.527,P<0.05,有统计学意义。结论：颈椎间盘不同退变程度的MRI表现能较好的反映其组织病理学变化，MRIPfirrmann分级系统评价椎间盘的退变程度II〜V级与临床分期1〜4期有一定对应关系，相对信号强度分级能更客观评价椎间盘退变程度，MRI评价椎间盘退变程度可为CSM的临床分期提供可靠的影像学依据。关键词：脊髓型颈椎病MRI病理临床分期AssociationstudyamongMRI，pathologyandclinicalstagesofthecervicalspondyloticmyelopathyPostgraduate:MaXiaoleiSupervisor:ProLChenJianchangAbstractObjective:TostudythecharacteristicsofMRIandpathologicalchangeofcervicaldegenerativediseases,andanalysisthecorrelationamongMRI>pathologicalchangesandclinicalstagesofcervicalspondyloticmyelopathy.Methods:AnalysisthepreoperativeT2weightedsignalofMR!of30diseaseddiscfrom23casesofcervicalspondyloticmyelopathypatientsundersurgicaltreatment,andmeasuretherelativesignalintensityofdiseaseddisc.WithPfirrmanngradingsystemdiseaseddiscdividedintomild,moderate,andseveredegeneration,HEstainingwascarriedouttoobservepathologicalchangesandevaluatethedegenerationdegree,thenanalysistwokindsofevaluationmethodsandanalysistheirconsistency.Thedataofmoderateandseveredegenerationfromrelativesignalintensityassessmentandhistopathologicalexaminationevaluationweremadeanalyzedandcompared.AtthesametimetheselectedcasesweredevidedintoclinicalstageswithcharacteristicsofMRIandpathologicalchange,andcomparedclinicalstageswithMRIcharacteristicsResults:Pfirrmanngradingandtherelatiesignalgradingsystemcomparedwithhistopathologicalgradingsystem,Kappavalueswere0.613,0.742respectively.andtherewashighconsistencyCoincidenceratebetweenPfirrmanngradingandclinicalstagewas69.6%;Thedataofmoderateandseveredegenerationfromrelativesignalstrengthassessmentwascompared,t=4.374,P<0.05,andtherewasstatisticalsignificance;Theaveragenumberoflivechondroidcellsmoderateandseveredegenerationfromrelativesignalstrengthassessmentwascompared,t=35Z1JP<0.05,andtherewasstatisticalsignificance.Conclusion:TheMRIperformanceofthedifferentdegreesofcervicaldiscdegenerationcanreflectpathologicalchanges,TherewasacertaincorrespondingrelationbetweenlevelII〜VofMRIandPfirrmanngradingsystemwithperiod1〜4oftheclinicalstages;Therelativesignalintensitygradingsystemcouldevaluationdiscdegenerationdegreemoreobjectively,theMRIassessmentprovidereliableimagingbasisfortheclinicalstagesofCSM.Keywords：CervicalspondyloticmyelopathyMRIPathologyClinicalstage中英文缩略词对照表英文缩写英文全名中文译名CSMCervicalspondyloticmyelopathy脊髓型颈椎病MRIMagneticresonanceimaging磁共振成像论文独创性...