磁共振成像在特发性脊柱侧凸患者研究中的应用:文献系统综述

O. M. Sergeenko, D. Savin, Y.V. Molotkov, M. Saifutdinov
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摘要

目标。分析特发性脊柱侧凸(IS)中隐藏的神经轴病理学的频率,证实在IS中需要MRI,并确定MRI在IS患者检查中的应用前景。材料和方法。文献综述使用PubMed和谷歌Scholar数据库进行。在780篇关于该研究课题的论文中,65篇在剔除重复并检查纳入/排除标准后被选中。因此,49项原始研究被纳入分析。证据水平- ii .结果。根据现代文献,在特发性脊柱侧凸中使用MRI的主要方向是寻找脊髓和颅椎交界处潜在病理的预测因子。特发性脊柱侧凸中神经轴病变的发生率在青少年is中为8%,在早期is中为16%。神经轴病变的主要预测因素为男性、畸形发病年龄早、左侧胸曲度和胸后凸过大。MRI在IS中可能是放射诊断方法的有用补充,以确定危险因素和研究脊柱的退行性改变。在IS早期应进行脊柱MRI检查,以发现潜在的脊髓栓系。对于I型Chiari异常,早期神经外科手术有可能预防脊柱侧凸的发展。根据Cobb的说法,IS的潜在神经轴病理的主要迹象是脊柱畸形的早期进展,左侧胸椎弯曲,男性和胸椎后凸超过40°。MRI可以作为一种有效的非侵入性工具,用于研究IS的危险因素,包括帮助追踪椎间盘的早期退变。
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The use of MRI in the study of patients with idiopathic scoliosis: a systematic review of the literature
Objective. To analyze the frequency of hidden neuraxial pathology in idiopathic scoliosis (IS), to substantiate the need for MRI in IS and to identify promising areas for the use of MRI in the examination of patients with IS.Material and Methods. The literature review was carried out using the PubMed and Google Scholar databases. Of the 780 papers on the research topic, 65 were selected after removing duplicates and checking for inclusion/exclusion criteria. As a result, 49 original studies were included in the analysis. Level of evidence – II.Results. According to modern literature, the main direction of using MRI in idiopathic scoliosis is the search for predictors of latent pathology of the spinal cord and craniovertebral junction. The frequency of neuraxial pathology in idiopathic scoliosis is 8 % for adolescent IS and 16 % for early IS. The main predictors of neuraxial pathology are male sex, early age of deformity onset, left-sided thoracic curve and thoracic hyperkyphosis. MRI in IS may be a useful addition to radiological diagnostic methods to identify risk factors and to study degenerative changes in the spine.Conclusion. MRI of the spine should be performed in the early stages of IS to detect latent spinal cord tethering. In type I Chiari anomalies, there is a possibility that early neurosurgery can prevent the development of scoliosis. The main signs of latent neuraxial pathology in IS are early progression of spinal deformity, left-sided thoracic curve, male gender and thoracic kyphosis over 40° according to Cobb.MRI can be used as an effective non-invasive tool in research aimed at identifying risk factors for IS, including helping to track early degeneration of intervertebral discs.
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