原发性低颅压综合征的脊柱磁共振诊断价值  

Diagnostic value of spinal MR imaging in spontaneous intracranial hypotension syndrome

作　　者：尚海龙[1] 沈海林[1] 杜红娣[1] 

机构地区：[1]上海交通大学医学院苏州九龙医院放射科,215021

出　　处：《实用医学影像杂志》2016年第3期188-191,共4页Journal of Practical Medical Imaging

基　　金：江苏省苏州市科技局科技发展计划(SYSD2014065)

摘　　要：目的探讨原发性低颅压综合征的颅脑和脊柱磁共振成像(MRI)诊断价值,以提高对该疾病的诊断认识。方法回顾性分析12例原发性低颅压综合征的颅脑和脊柱MRI表现。结果 12例患者中颅脑MRI表现弥漫性硬脑膜强化(9例,75%),硬膜下积液(6例,50%),垂体肿胀(5例,41%),小脑扁桃体下移(4例,33%)。脊柱MRI表现:硬膜外积液伴脊压征(92%,11/12),硬膜外静脉丛扩张(7/12,58%),硬脊膜强化(5/7,71%),C1-2附件区或脊柱神经根鞘周围T2高信号(8/9,89%),神经根鞘囊肿(4/9,44%)。原发性低颅压综合征颅脑表现MRI敏感性75%(9/12),脊柱MRI表现敏感性92%(11/12)。结论脊柱MRI有助于SIH的临床诊断及病因查找,在原发性低颅压综合征的诊断中有重要指导价值。Objective To explore the diagnostic value of brain and spinal MR imaging in spontaneous in-tracranial hypotension syndrome and to improve the diagnosis of this disease. Methods The sensitivities for the de-tection of SIH were retrospectively evaluated in patients with SIH treated in our institutions. Results Of 12 cases, by Brain MR imaging ,there were 9 cases （75%） with diffuse pachymeningeal enhancement, 6 cases（50%） with subdu-ral fluid collection, 5 cases （41%） with enlargement of the pituitary gland, 4 cases with descent of the cerebellar tonsil （33%）, while by spinal MR imaging 11 patients were detected as epidural fluid collection on fat-saturated T2-weighted images （92%）, dilated epidural veins in 7 patients （58%）, dural enhancement in 5 patients undergoing contrast admin-istration （71%）, high T2 signal intensity between the spinous processes of high-cervical （C1-2）or along the nerve roots in 8 of the 9 patients （89%） and abnormal visualization of the nerve root sleeve in 4 of 9 patients （44%）. The sensi-tivity for SIH was 75% for brain MR imaging and 92% for spinal MR imaging. Conclusion Spinal MR imaging is useful for the diagnosis of SIH.

关 键 词：颅内压 脊柱 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741[医药卫生—诊断学]