在過去三年中,共收集四十例頸椎後縱韌帶骨化病例,分析其鈣化韌帶在磁振造影上的表現,並與電腦斷層影像對照。 研究結果顯示:軸狀切面、以T2為主的影像對脊椎後縱韌帶骨化的診斷敏感度最高,應列為檢查中的常規性脈衝序列。而以T1及T2為主的矢狀切面,則較能分析鈣化韌帶的訊號變化。對於前後徑變寬而高度並未減低、或失去正常凹弧形後緣的脊椎,都要高度懷疑脊椎後縱韌帶骨化的存在。此外,除較薄韌帶磁振造影不易偵側外,大部份鈣化韌帶在磁振造影及電腦斷層上的表現相似。磁振造影最大的優點是它可以評估脊髓受壓迫的情況,預測手術可能的預後。 對脊椎後縱韌帶骨化的診斷,電腦斷層仍是主要的影像學工具,但在磁振造影常被用為第一線篩檢工具的今日,吾人應熟習其在磁振影像上的表現,以避免誤診而影響病人的治療。
To investigate the magnetic resonance (MR) appearance of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. A retrospective analysis of MR images in 40 patients with diagnosed as OPLL. Correlation of the MR images with computed tomography (CT) was made. Axial T2-weighted MR images are the most practical and the best pulse sequence for identifying OPLL. Combined Ti- weighted and T2- weighted sagittal MR images are necessary in evaluating the signal change of OPLL. MR can noninvasively assess the degree of spinal cord compression. Increased anteroposterior diameter or loss of posterior concavity of the vertebral body give rise to a suspicion of OPEL. Axial MR images are more sensitive than the sagittal and should be done routinely in diagnosing OPEL.