转移瘤脊髓压迫症运动功能损害与影像学特征的相关性VIP专享VIP免费

．1606·生堡匡堂盘查垫!Q生垒旦!!旦筮塑鲞筮垫翘堕趔丛鲴』￡h丝，巫坚!!：垫!!：!堂：堕：盟!：垫转移瘤脊髓压迫症运动功能损害与影像学特征的相关性刘蜀彬刘耀升李鼎锋范海涛槐建业郭钧王磊刘铖张平崔秋姜维浩曹云岑江宁隋佳红张斌周举【摘要】目的探讨转移瘤硬膜外脊髓压迫症(MESCC)运动功能损害与影像学特征的相关性。方法自2006年7月至2008年12月，对连续收治的56例MESCC患者入院后按Frankel分级进行瘫痪状态评估，并进行主要病变脊椎的MRI及cT扫描。主要病变脊椎影像学评估因素包括：病变脊椎节段、侵犯硬膜外间隙、累及椎板、椎体后壁向后突出、病变脊椎连续、累及椎弓根、椎体前柱骨折、椎体后壁骨折、病变脊椎位于上胸椎和(或)颈胸交界。结果本组56例MESCC患者瘫痪状态与侵犯椎管内硬膜外组织的影像学特征发生状况完全一致。多元回归方程表明MESCC瘫痪状态与累及椎板(置)、椎体后壁向后突出(置)、病变脊椎位于颈胸交界处和上胸椎(玛)等影像学特征存在线性回归关系。MESCC瘫痪状态(y)与影像学特征(X)的最优回归方程为Y=-0．009+O．639X1+0．149X2+0．282X7，其中累及椎板对MESCC瘫痪状态影响最大。结论影像学特征中累及椎板、椎体后壁向后突出、病变脊椎位于上胸椎和(或)颈胸交界可预测MESCC的瘫痪状态，累及椎板的MESCC患者最易向硬膜外间隙侵犯。【关键词】肿瘤转移；硬膜外肿瘤；运动障碍RelationshipofmotordeltdtsandUm西mgfeaturesinmetastaticepi山lral删cordcon哪ressionLIUshu—bin．UUYao—sheng．12Ding-feng．FANHal—tao．HUA|Jian-ye．GUOJun，WANGLei，uUCheng．ZHANGAng，CUIQiu，JIANGWei—hao，CAOYtm-cen，flANGNing，SUIJia—hong，ZHANGBin，ZHOU^u’DepartmentofOrthopedicSurgery，PLA307thHospital，Beijing100071，ChinaCorrespondingauthor：ⅡUl，幻《7诂增，Email：髓ly鲫|Ile，lgDDJ@yahoaconkcn【Abstract】OMectiveToexploretherelationshipofmotordeficitsofthelowerextremitieswiththeimagingfeaturesofmalignantspinalcordcompression(MESCCs)．MethodsFromJuly2006throughDecember2008，56successiveMESCCpatientsweretreatedatourdepartment．AllwereevaluatedbymagneticreuniteimagingandcomputedtomographyandwerescoredaccordingtomotordeficitsFrankelgradingonadmission．Imagingassessmentfaetomofmaininvolvedvertebraewerelevelofvertebralmetastasticlocation，epiduralspaceinvolvement，vertebralbodyinvolvement，lami珊involvement，posteriorprotrusionofposteriorwall，pedicleinvolvement，continuityofmaininvolvedvertebrae，fractureofanteriorcolumn，fractureofposteriorwall，locationinupperthoracicspineand／orcervicothoraciejunction．ResultsOccurrenceWaSthesalnebetweenparalyticstateofMESCCsandepiduralspaceinvolvementofimaginSfeatures．Multipleregressionequationshowedthatparalyticstatehadalinearregressionrelationshipwithimagingfactorsoflaminainvolvement(置)，posteriorprotrusionofposteriorwall(五)，locationinupperthoracicspineand／orcervicothoraciciunction(X7)ofmaininvolvedvertebrae．Theoptimalregressionequationofparalyticstate(Y)andimagingfeature(X)WasY=一0．009+0．639X1+0．149X2+0．282X．I．．a／ninainvolvementofrnBininvolvedvertebraehasagreatestinfluenceuponparalyticstateofMESCCpatients．ConclusiomImagingfactorsoflaminainvolvement，posteriorprotrusionofposteriorwall，locationinupperthoracicspineand／orcervieothoracicjunctionofmaininvolvedvertebraeCanpredicttheparalyticstateofMESCCpatients．MESCC研tIllaminainvolvementismoreeasilyencroachedonepidural叩ace·【Keywords】Neoplasmmetastasis；Epiduralneoplasm；MovementdisordersDOI：10．3760／cms．j．issn．0376-2491．2010．23．006作者单位：100071北京解放军第ZO七医院骨科通信作者：刘耀升，Email：Liuyaoshen9001@yahoo．corn,cn．临床研究．转移瘤硬膜外脊髓压迫症(...