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目的探讨颈椎主动屈曲位屈曲度异常的X线征象对平山病的诊断价值。资料与方法对40名正常自愿者及35例临床疑诊平山病的患者行颈椎仰卧被动过屈位MRI扫描及颈椎主动屈曲位平片检查。疑诊的35例中有25例根据临床及影像学征象被诊断为平山病。测量确诊患者和正常对照组平片以及MRI上的C3～7相邻两两椎体后缘的成角,作为颈椎屈曲度的评价指标。结果确诊患者主动屈曲位平片颈椎屈曲度较对照组增大(患者C3～7相邻两两椎体后缘成角分别为7.40°、8.50°、10.60°、11.10°,均较对照组增大(P<0.05)。将颈椎屈曲度异常作为平山病的征象之一,其对于平山病诊断的敏感性为96.00%,特异性为87.50%。描绘受试者操作特征曲线(ROC),曲线下面积为0.93。结论平山病患者颈椎屈曲度在C3～7段均大于正常对照组。结合临床症状与体征,颈椎主动屈曲位平片所反映的屈曲度异常征象对于平山病的诊断价值较高,在无法施行颈椎仰卧被动过屈位MRI时,该检查可作为平山病的辅助诊断方法。
Objective To investigate the diagnostic value of X-ray findings of active cervical flexion-flexion abnormalities in Pingshan disease. Materials and Methods Forty patients with normal volunteers and 35 patients with clinically suspected psoriasis were examined with MRI scan of cervical supine passive flexion and flexion plain radiographs. Twenty-five of the 35 suspected cases were diagnosed as Pingshan by clinical and radiographic signs. The angulation of the posterior edge of the two adjacent vertebrae between C3 and 7 on the plain film of the diagnosed patient and the normal control group and on MRI was evaluated as an index of evaluating the degree of cervical flexion. Results The flexion and flexion of patients with active flexion and flattening of the cervical spondylolisthesis were significantly higher than those of the control group (angulation of 7.40 °, 8.50 °, 10.60 ° and 11.10 ° respectively) (P0.05) .The cervical spine flexion abnormality was one of the signs of Pingshan disease.The sensitivity and specificity of the method were 96.00% and 87.50%, respectively.The Plot of the operation characteristic curve (ROC), curve The area under the curve was 0.93.Conclusions The flexion of cervical spine in patients with Pingshan disease is greater than that in the normal control group at C3-7 stage.According to the clinical symptoms and signs, the abnormal flexion reflected by active cervical flexion plain radiographs has a higher diagnostic value for Pingshan disease , Can not be used in cervical supine passive flexor MRI, the examination can be used as an auxiliary diagnosis of Pyeongshan disease.