小儿脊髓栓系综合征中脊髓积水空洞磁共振成像大小变化特点及分析  

Characteristics and analysis of MRI size changes of syringohydromyelia in children with tethered cord syndrome

作　　者：李荣品[1] 侯振洲[1] 焦祺[1] 王伟秀[1] 丛力宁[1] 魏华滨 LI Rongpin;HOU Zhenzhou;JIAO Qi;WANG Weixiu;CONG Lining;WEI Huabin(Department of CT/MR,the Children’s Hospital of Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院CT/MR科,河北石家庄050031

出　　处：《实用放射学杂志》2020年第6期953-955,987,共4页Journal of Practical Radiology

摘　　要：目的研究小儿脊髓栓系综合征(TCS)中脊髓积水空洞(SM)MRI大小变化特点。方法回顾性分析53例小儿TCS合并SM患儿MRI测量空洞大小变化特点。根据不同临床治疗方法分组分析,其中无临床治疗组8例(Ⅰ组),临床行脊髓栓系松解术32例(Ⅱ组),行脊髓栓系松解术同时空洞切开引流术13例(Ⅲ组)。多次随访测量每组空洞值大小,总结不同治疗方法各组空洞值变化特点,并进行组间分析。结果Ⅰ组8例患儿,随访空洞无明显变化1例,不同形式增大7例;Ⅱ组32例,术后1个月空洞缩小17例,无变化13例,增大2例,其中21例术后3个月~5年复查,空洞与术后1个月比较缩小12例,无变化5例,先缩小后增大4例;Ⅲ组13例,术后1个月空洞均明显缩小,其中9例术后6个月~1.5年复查,空洞与术后1个月比较无变化4例,缩小2例,3例增大。术后1年复查病例中,Ⅱ组18例,Ⅲ组9例,与术前空洞大小比较分析,Ⅱ组空洞缩小10例(55.6%),无明显变化6例(33.3%),增大2例(11.1%);Ⅲ组空洞缩小8例(88.9%),增大1例(11.1%)。空洞缩小率2组间比较无统计学差异(P=0.09)。SM增大率未手术组(Ⅰ组)与手术组(Ⅱ组+Ⅲ组)比较分析,有统计学意义(P=0.00)。结论小儿TCS合并SM未手术治疗空洞呈增大趋势,术后空洞绝大部分缩小,小部分变化多样。脊髓栓系松解术与脊髓栓系松解术同时空洞切开引流术对改变术后脊髓空洞缩小程度无明显差别。Objective To study the characteristics of MRI size changes of syringohydromyelia(SM)in children with tethered cord syndrome(TCS).Methods The change of cavity size measured by MRI in 53 children with TCS and SM were analyzed retrospectively.According to the analysis of different clinical treatment groups,there were 8 cases in the non-clinical treatment group(groupⅠ),32 cases in the spinal cord tie-down released group(groupⅡ),13 cases in the spinal cord tie-down released simultaneously syringomyelia drainage group(groupⅢ).After several follow-up measurements,the size of each group was measured,and the characteristics of the changes of each group were summarized with different treatment methods,and the inter-group analysis was carried out.Results In 8 cases of groupⅠ:1 patient had no significant change in follow-up cavity,7 cases were increased in different forms.In 32 cases of groupⅡ:17 cases were reduced,13 cases were unchanged,2 cases were increased after 1 month of operation;in 21 cases which were reviewed from 3 months to 5 years after operation,the voids were reduced in 12 cases,unchanged in 5 cases,reduced and then enlarged in 4 cases,which compared with 1 month after surgery.And in 13 cases of groupⅢ:all the voids were significantly reduced in 1 month after operation;among them,9 cases were followed-up from 6 months to 1.5 years after the operation,4 cases were unchanged,2 cases were reduced and 3 cases were enlarged compared with 1 month after surgery.Among the 1-year postoperative re-examination cases,18 cases were in groupⅡand 9 cases were in groupⅢ.Compared with the size of the preoperative cavity,10 cases(55.6%)were reduced in groupⅡ,6 cases(33.3%)had no significant change,and 2 cases(11.1%)were increased;In groupⅢ,8 cases(88.9%)were reduced,1 case(11.1%)were increased.There was no significant difference in the reduction rate between the two groups(P=0.09).The increase rate of SM was compared between the non-operative group(groupⅠ)and the operation group(groupⅡ+groupⅢ),which wa

关 键 词：小儿 脊髓积水空洞 脊髓栓系综合征 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]