方法:这是一项连续病例系列的头部下垂综合征(DHS)的回顾性研究。
目的:确定DHS患者的对比增强磁共振成像(MRI)的特征性特征。
背景:孤立性颈伸肌病DHS(INEM-DHS)被认为是由年龄相关的弹性丧失引起的严重颈伸肌无力。然而,尚未对DHS患者颈部伸肌的MRI表现进行表征。
方法:受试者为34例INEM-DHS患者,发病后7个月内行对比增强MRI检查,32例年龄匹配的颈椎病或颈椎软组织肿瘤患者作为对照。在颈伸肌中存在增强的发现,涉及的宫颈水平,并使用对比增强MRI评估这些肌肉的特征性增强形状。
结果:在DHS组中,增强MRI显示34例脾炎明显增强,菱形23例,颈半肌7例,肩胛骨提上肌3例。在非国土安全部组中,这些伸肌都没有增强。29例(85.3%)呈蝶形增强,5例(14.7%)呈线形增强。在DHS组中,全部位于C6或C7处的棘突附着处。在非国土安全部组中,7例表现为棘突增强图像,C5-6在1种情况下,C65例,和C7在1个案例中。
结论:在国土安全部,对比增强MRI显示颈部伸肌肌内增强,这在非DHS病例中不存在。在所有情况下,增强的肌肉都包括脾capitis肌肉。这些发现可能有助于制定DHS治疗策略。
METHODS: This is a retrospective study of a consecutive case series of dropped head syndrome (DHS).
OBJECTIVE: To identify the characteristic features of contrast-enhanced magnetic resonance imaging (MRI) in DHS patients.
BACKGROUND: Isolated neck extensor myopathy DHS is thought to be caused by severe cervical extensor muscle weakness from age-related loss of elasticity. However, the MRI findings of the cervical extensor muscles in DHS patients have not yet been characterized.
METHODS: The subjects were 34 patients with isolated neck extensor myopathy DHS who underwent contrast-enhanced MRI within seven months after onset and 32 patients with age-matched cervical spondylosis or cervical soft-tissue tumor as controls. The presence of enhanced findings in the cervical extensor muscles, the involved cervical levels, and the characteristically enhanced shape of those muscles were evaluated using contrast-enhanced MRI.
RESULTS: In the DHS group, the contrast-enhanced MRI showed pronounced enhancement at splenius capitis in 34 cases, rhomboid in 23 cases, semispinalis cervicis in seven cases, and levator scapulae in three cases. In the non-DHS group, none of those extensor muscles were enhanced. The enhanced pattern was butterfly shaped in 29 cases (85.3%) and linear in five cases (14.7%). All were located at the spinous process attachment at C6 or C7 in the DHS group. In the non-DHS group, seven cases presented an enhanced image of the spinous process, with C5-6 in one case, C6 in five cases, and C7 in one case.
CONCLUSIONS: In DHS, contrast-enhanced MRI showed intramuscular enhancement of the cervical extensor muscles, which was not present in non-DHS cases. The enhanced muscles included the splenius capitis muscle in all cases. These findings may be useful for developing a strategy for DHS treatment.