特发性青少年脊髓空洞症患儿后颅窝线性容积的改变及临床意义  

Morphometric analysis of the posterior fossa in adolescents with idiopathic syringomyelia

作　　者：闫煌[1] 朱泽章[1] 邱勇[1] 沙士甫[1] 江龙[1] 伍伟飞[1] 杨宗[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,210008

出　　处：《中华小儿外科杂志》2013年第9期651-654,共4页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金面上项目（81171672）;中国博士后基金特别资助项目（2012T50464）

摘　　要：目的评估青少年特发性脊髓空洞（idiopathic syringomyelia，IS）患儿后颅窝线性容积，并探讨其临床意义。方法从2008年1月至2011年10月我院诊断为IS的病例中选择影像学资料完整的青少年患儿25例（IS组）。同时选取性别、年龄匹配的继发于Chiari畸形I型的脊髓空洞（Chiarimalfor mation type I＆ syringomyelia，CMI-S）患儿（CMI-S组）及正常青少年作为对照组。在正中矢状面MR影像上分别测量三组患儿后颅窝线性容积的距离指标（后颅窝斜坡长度、枕骨大孔径、枕上长度、后颅窝矢状径、后颅窝高径）和角度指标（后颅窝斜坡倾斜角），并运用单向方差分析统计三组患儿后颅窝各测量指标间的差异。结果IS组后颅窝斜坡长度25．4～48．7mm（平均38．3mm）；枕骨大孔前后径27．2～44．2mm（平均33．6mm）；枕骨鳞部长度23．6～48．2mm（平均36．7mm）；后颅窝矢状62．9～88．4mm（平均74．3mm）；后颅窝高径18．5-43．9mrn（平均31．3mm）及斜坡倾斜角30．0°-77．0°（平均56．7°）。IS组与CMI-S组患儿的后颅窝线性容积各测量指标均显著小于正常青少年，差异有统计学意义（P〈0.05）。IS组患儿后颅窝斜坡倾斜角为56.7°±10．6°，显著大于CMI-S组患儿50．8儿±11．7儿，差异有统计学意义（P〈0．05），其余指标差异没有统计学意义（P〉0．05）。结论IS患儿与CMI-S患儿均存在后颅窝骨性结构的发育异常。与CMI-S患儿相比，IS患儿具有较为陡直的斜坡结构。Objective To investigate the morphometric characteristics of the posterior fossa in adolescents with idiopathic syringomyelia （IS） and to elucidate the clinical significances. Methods A retrospective radiographic review was performed on 25 adolescents who were diagnosed as IS and trea ted at our clinic between January 2008 and October 2011. Another cohort of normal adolescents and chiari malformation type I ＆ syringomyelia（CMI-S） patients, matched with the IS patients in age and gender, were recruited as the control group. Six parameters were assessed in mid-sagittal MR images, including the linear parameters （the length of the clivus, the anteroposterior diameter of the foramen magnum, the length of supraocciput, the anteroposterior diameter of the posterior fossa, the posterior fossa height） and the angular parameter （the clivus gradient）. Results In the IS group, the length of the clivus ranged from 25.4 mm to 48. 7 mm （mean 38. 3 mm） ; the anteroposterior diameter of the foramen magnum ranged from 27. 2 mm to 44. 2 mm （mean 33. 6 mm）; the length of supraocciput ranged from 23.6 mm to 48. 2 mm （mean 36. 7 mm）, the anteroposterior diameter of the posterior fossa ranged from 62. 9 mm to 88. 4 mm （mean 74. 3 mm）, the posterior fossa height ranged from 18.51 mm to 43.9 mm （mean 31.3 mm） and the clivus gradient ranged from 30. 0 to 77.0 （mean 56. 7）. Significant differences were observed in all the six morphometric parameters when comparing the IS group and CMI-S group with the normal group respectively. Additionally, all parameters were similar between the IS and CMI-S groups except for the clivus gradient which was significantly larger in the IS group （56. 69 ± 10. 6, P〈0. 05）. Conclusions The posterior fossa in patients with IS, sharing thesimilar characteristics with these in patients with CMI-S, is indeed smaller than normal. A steeper clivus is observed in patients with IS when compared with that in patients with CMI-S.

关 键 词：脊髓空洞症 颅窝 后 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学]