脊髓纵裂畸形的影像学诊断和治疗  

Imageological diagnosis and treatment of diastematomyelia

作　　者：程敬亮[1,2] 任翠萍[1,2] 李树新[1,2] 李荫太[1,2] 王建平[1,2] 杨波[1,2] 

机构地区：[1]河南医科大学第一附属医院放射科 [2]河南医科大学第一附属医院神经科

出　　处：《河南医科大学学报》1997年第4期12-14,共3页Journal of Henan Medical University

基　　金：河南省科技攻关基金

摘　　要：为了探讨脊髓纵裂（ＤＭ）的分型和手术适应证，比较Ｘ线平片、ＣＴ和ＭＲＩ对ＤＭ的诊断价值。经手术证实的１３例ＤＭ，均有脊柱Ｘ线平片、平扫ＣＴ和ＭＲＩ。将ＤＭ分为有隔刺的Ⅰ型和无隔刺的Ⅱ型。Ⅰ型分为有完整隔刺的Ⅰａ型和不完整隔刺的Ⅰｂ型；Ⅱ型分为完全纵裂的Ⅱａ型和不全纵裂的Ⅱｂ型。结果：１３例ＤＭ中Ⅰａ型７例、Ⅰｂ型１例、Ⅱａ型４例、Ⅱｂ型１例。Ｘ线平片确诊ＤＭ５例，ＣＴ确诊１１例，ＭＲＩ全部正确诊断。８例Ⅰ型ＤＭ中５例为骨性隔刺，ＣＴ全部正确诊断，ＭＲＩ仅２例确定为骨性隔刺。结论：ＭＲＩ是诊断ＤＭ及其椎管内伴发病变的最有效方法，但对Ⅰ型ＤＭ骨性隔刺显示ＣＴ优于ＭＲＩ。有神经损害的Ⅰ型ＤＭ或无神经损害儿童Ⅰ型ＤＭ应尽早手术切除隔刺。n order to explore the classification,and operative indication of diastematomyelia(DM),and compare the diagnostic value of roentgenograms,CT and MRI for DM,13 patients with DM verified by operation were reported.All patients underwent roentgenograms,plain CT and MRI of the spine,and they were divided into two groups:Type Ⅰ with and Type Ⅱ without a spur.Type Ⅰ was subdivided into complete form of the spur (Type Ⅰa)and incomplete one (TypeⅠb),while Type Ⅱ was subdivided into complete (Type Ⅱa)and incomplete (Type Ⅱb)vertically divided cord. Results:Seven of 13 cases of DM belonged in Type Ⅰa ,1 case Type Ⅰb, 4 cases Type Ⅱa and 1 case Type Ⅱb.Roentgenogram,plain CT and MRI correctly diagnosed 5,11 and 13 cases of 13 cases of DM,respectively.In 8 cases of Type Ⅰ DM,5 cases of osseous spurs were correctly determined by plain CT,while 2 cases of osseous spurs of only determind by MRI.Our Results demonstrated that MRI was the most effective method for diagnosing DM itself and its intracanal related anomalies.However,the osseous spur was better shown on plain CT.Spurs of Type Ⅰ DM in childen without clinical manifestatson of nerve injury or in patients with clinical manifestation or nerve injury should be removed.

关 键 词：脊髓纵裂 先天性脊柱畸形 治疗 X线诊断 

分 类 号：R744.04[医药卫生—神经病学与精神病学] R814[医药卫生—临床医学]