腰骶部先天发育异常的MRI评价及其与神经源性功能障碍间的关系探讨  

MRI evaluation in congenital lumbosacral dysplasia and the relationship with neurogenic dysfunction

作　　者：纪宇[1] 黄玲[1] 崔勇[1] 王若义[2] 张淑惠 JI Yu;HUANG Ling;CUI Yong;WANG Ruoyi;HANG Shuhui(Department of Radiology,Second Hospital of Shandong University,Jinan 250033,P.R.China;Pediatric Surgery,Second Hospital of Shandong University,Jinan 250033,P.R.China;Clinical Laboratory,Second Hospital of Shandong University,Jinan 250033,P.R.China)

机构地区：[1]山东大学第二医院医学影像中心,山东济南250033 [2]山东大学第二医院小儿外科,山东济南250033 [3]山东大学第二医院检验科,山东济南250033

出　　处：《医学影像学杂志》2018年第8期1355-1358,共4页Journal of Medical Imaging

基　　金：山东省自然科学基金项目(编号:ZR2014HL082)

摘　　要：目的探讨MRI对腰骶部先天发育异常的诊断价值及其与神经源性功能障碍之间的关系。方法分析95例腰骶部先天发育异常患儿的MR图像,分别评价其脊髓、腰骶椎的发育状况以及任何存在的椎管及骶尾部占位性病变;同时观察泌尿系统及肛直肠的发育状况。结果 95例患儿中,脊髓发育异常86例,其中脊髓栓系79例,脊髓发育不全7例;另外9例为骶尾部畸胎瘤。有29例患儿伴随腰骶椎发育不全,末端分别终止于骶1-尾1的不同水平。在神经源性功能障碍方面,13例患儿表现为单纯排尿功能障碍,18例单纯排便功能障碍,64例二者兼有,其中23例合并下肢功能障碍。脊髓发育异常及畸胎瘤造成的神经损害与神经源性功能障碍的发生具有显著地相关性,而腰骶椎发育不全与脊髓发育异常及神经源性功能障碍之间没有相关性。结论脊髓发育异常及骶尾部畸胎瘤可能是造成儿童神经源性功能障碍的主要病因,MRI对早期诊断具有重要价值。Objective To investigate the value of MRI in the diagnosis of congenital dysplasia of lumbosacral region and to probe its relationship with neurogenic dysfunction. Methods The lumbosacral MR images of 95 patients with congenital malformations were retrospectively analyzed to evaluate the development of the spinal cord,lumbosacrum,as well as intraspinal or sacrococcygeal mass lesions and to observe the development of the urinary and anorectal conditions. Results In 95 cases,abnormal spinal cord developments were found in 86 cases,tethered spinal cord in 79 cases,spinal cord agenesis in 7 cases; the other 9 cases were sacrococcygeal teratomas. There were 29 patients with lumbosacral agenesis,and the ends terminated from sacrum 1 to coccyx 1. In terms of neurogenic dysfunction,simple voiding dysfunction was found in 13 children,bowel dysfunction in 18 cases,64 cases of both,23 patients presented with lower extremity dysfunction. Nerve damage caused by spinal cord dysplasia and teratoma and neurogenic dysfunction had significant relevance,but there was no correlation between lumbosacral agenesis and spinal cord dysplasia and neurogenic dysfunction. Conclusion Spinal cord development abnormalities and sacrococcygeal teratomas may have contributed to the main causes of neurogenic dysfunction in children,and the value of MRI in early diagnosis is important.

关 键 词：脊髓发育不良 骶尾部畸胎瘤 神经源性功能障碍 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R445.2[医药卫生—外科学]