超声在Chiari1畸形枕大池重建减压术中的应用  

Value of intraoperative ultrasound in evaluation of suboccipital decompression

作　　者：程令刚[1] 何文[1] 王立淑[1] 李晨[1] 杨俊[2] 

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京市100050 [2]首都医科大学附属北京天坛医院神经外科,北京市100050

出　　处：《临床超声医学杂志》2013年第9期619-621,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声在ChiariI畸形大池重建减压术中的应用价值。方法47例ChiariI畸形患者术中咬除枕骨鳞部部分骨质后，分别于硬膜剪开前及硬膜减张修补缝合后行超声检查，观察枕大池范围及延髓小脑搏动幅度变化。术后依据Tator评分对各患者评分分组，观察手术效果与术中超声结果的相关性。结果本组患者术后Tator评分35例为优，12例为良，无术后恶化者，术后改善率为74．47％。硬膜减张修补缝合后枕大池范围及小脑延髓搏动幅度较硬膜剪开前明显增加，差异有统计学意义。优、良组间枕大池范围及小脑延髓搏动度差异有统计学意义。术后3～18月随访，MRI显示42例合并脊髓空洞患者中38例明显缩小甚至消失，枕大池重现。结论术中超声可对颅后窝小骨窗减压枕大池重建术治疗ChiariI畸形的疗效进行即刻、量化评价，对预测术后疗效有一定价值。Objective To investigate the value of intraoperative ultrasound in evaluating the effect of reconstruction of the cisterna magna of Chiari I malformation. Methods The cisterna magna and cerebellobulbaris impulse amplitude through intraoperative BUS were measured using irtraoperative ultrasound after the skull opening and postoperation. The effect of decompression was evaluated. Patients were evaluated and then grouped according to Tator test. The scores were compared with the intraoperative ultrasound results. Results According to Tator Score, 35 patients were defined as good, 12 patients were defined as fine, and no one was aggravate. The rate of score postoperation improvement was 74.47%. The cubage of the cisterna magna and cerebellobulbaris impulse amplitude after decompression increase prominently, the difference is significant. The difference of the changes of cerebellobulbaris impulse amplitude among groups according to Tator Score was significant. MRI showed the syringomyelia shrinked or even disappeared in 38 of 42 patients, and the cisterna magna was reconstructed. Conclusion Intraoperative ultrasound can evaluate the results of reconstruction of the cisterna magna and suboccipital depression in patients with Chiari I malformation in quantization, and could be adopted as a useful method of prognosis prediction.

关 键 词：CHIARII畸形 术中超声 枕大池重建术 

分 类 号：R445.1[医药卫生—影像医学与核医学]