Objective To evaluate the feasibility and diagnostic value of shear wave elastography (SWE)in assessing spinal cord dysfunction in patients with cervical spondylotic myelopathy. Methods Twenty-six patients with myelopathy were included in our study,the cord compression rate was evaluated by preoperation MRI,and Japanese Orthropeadic As-socition (JOA)scores were also evaluated. All patients were treated by cervical laminoplasty,the elastic modulus of nor-mal segment and the compressed segment spinal cord were measured by Supersonic Imagine AixPlorer real-time SWE,and the decline ratio of the elastic modulus was also calculated;the relationships between the age,duration of disease,cord compression rate,JOA scores and the decline ratio of elastic modulus were analyzed. Results The elastic modulus of com-pressive segment was significantly lower than those of normal spinal cord (P < 0. 01). The decline ratio of elastic modulus was 42. 4％ ± 23. 5％ . There was no significant correlation between the age,duration of disease,cord flattening rate and the decline ratio of elastic modulus (r = 0. 147,0. 268,0. 262,all P > 0. 05). There was a significant negative correlation between JOA scores and the decline ratio of elastic modulus (r = - 0. 426,P = 0. 03). The ICC of the normal segment e-lastic modulus was 0. 959 (95％ CI:0. 912 - 0. 982),and the ICC of the compressed segment elastic modulus was 0. 832 (95％ CI:0. 660 - 0. 921). Conclusions SWE could distinguish the normal and compressed spinal cord and the decline ratio of elastic modulus could reflect the spinal cord dysfunction.%目的 探讨剪切波弹性成像(SWE)技术评估脊髓型颈椎病患者脊髓功能障碍的价值.方法 选择脊髓型颈椎病患者26例,术前行颈椎MRI检查测算病变节段脊髓的扁平率,并用日本骨科协会(JOA)评分对脊髓功能进行评价.患者均行棘突纵割式椎板成形术治疗,术中用Supersonic Imagine AixPlorer型实时SWE超声诊断仪测量正常节段与病变节段脊髓的弹性模量,计算脊髓弹性模量下降比;分析患者年龄、病程、脊髓扁平率、JOA评分与脊髓弹性模量下降比间的关系,用组内相关系数(ICC)检验SWE技术的可重复性.结果 患者病变节段脊髓的弹性模量低于正常节段脊髓的弹性模量(P<0.01).脊髓弹性模量下降比为42.4％ ±23.5％.脊髓弹性模量下降比与患者年龄、病程、病变节段脊髓扁平率无相关性(r分别为0.147、0.268、0.262,P均>0.05),与术前JOA评分呈负相关(r=-0.426,P<0.05).正常节段脊髓弹性模量的ICC为0.959(95％CI:0.912～0.982),病变节段脊髓弹性模量的ICC为0.832(95％CI:0.660～0.921),SWE测量脊髓弹性模量有很好的可重复性.结论 SWE检查可区分脊髓型颈椎病患者的正常与病变脊髓,其测算的弹性模量下降比可反映脊髓功能障碍程度.
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