Chiari畸形合并脊髓空洞(CM-SM)手术前后的MR影像表现  

MR Images before and after Surgery for Chiari Malformation with Syringomyelia(CM-SM)

作　　者：王冬青 董安珂 娄永利 WANG Dong-qing;Dong An-ke;LOU Yong-li(Department of Radiology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan Province,China)

机构地区：[1]郑州大学附属郑州中心医院放射科,河南郑州450007

出　　处：《中国CT和MRI杂志》2024年第3期48-51,共4页Chinese Journal of CT and MRI

基　　金：2022年河南省重点研发与推广专项(科技攻关)项目(222102310652)。

摘　　要：目的探究Chiari畸形合并脊髓空洞(CMSM)手术前后的MR影像表现,分析其病因。方法选择本院收治的33例CM-SM患者为研究对象,对其临床资料和术前、术后M R影像资料进行回顾性分析。结果术后经MRI检查提示,脊髓空洞明显缩小的有26例,脊髓空洞轻微变小的偶6例,无明显变化的1例。手术后患者枕大池成形较好,小脑下疝堵塞有所改善,脑室出口通畅,术后蛛网膜下腔脑脊液明显多于术前。术前患者的中脑导水管脑脊液RF、MF、SV均明显少于术后6个月,V_(dmax)与V_(umax)高于术后6个月,对比差异显著(P<0.08);术前患者的桥延池脑脊液MF、SV明显少于术后6个月,V_(dmax)与V_(umax)高于术后6个月,对比差异显著(P<0.05)。术前与术后6个月的RF对比,无显著差异(P>0.05);术前患者的C2-3椎间盘脑脊液MF、SV均明显少于术后6个月,V_(dmax)与V_(umax)高于术后6个月,对比差异显著(P<0.05)。术前与术后6个月的RF对比,无显著差异(P>0.05)。结论MRI用于CN-SM患者手术前后检查,可以确定枕大孔区不全梗阻引起的脑脊液循环异常可形成脊髓空洞,经手术治疗后,枕大孔区梗阻解除,恢复脑脊液流动。Objective To investigate the MR imaging manifestations of Chiari malformation with syringomyelia(CM-SM)before and after surgery,and to analyze its etiology.Methods 33 patients with CM-SM admitted to our hospital were selected as the research objects,and their clinical data,preoperative and postoperative MR imaging data were retrospectively analyzed.Results According to MRI examination after operation,there were 26 cases with obvious shrinkage of syringomyelia,6 cases with slight shrinkage of syringomyelia,and 1 case with no obvious change.After operation,the formation of the cistern magna was better,the blockage of subcerebellar hernia was improved,the outlet of the ventricle was unobstructed,and the cerebrospinal fluid in the subarachnoid space was significantly more than that before operation.The midbrain aqueduct cerebrospinal fluid RF,MF,and SV of patients before operation were significantly less than 6 months after operation,and V_(dmax) and V_(umax) were higher than 6 months after operation,and the difference was significant(P<0.05);The MF and SV of the cerebrospinal fluid in the pool were significantly less than 6 months after operation,and the V_(dmax) and V_(umax) were higher than 6 months after operation,the difference was significant(P<0.05).There was no significant difference in RF before operation and 6 months after operation(P>0.05);the MF and SV of C2-3 intervertebral disc cerebrospinal fluid of patients before operation were significantly lower than those at 6 months after operation,and V_(dmax) and V_(umax) were higher than those at 6 months after operation.At 6 months,there was a significant difference(P<0.05).There was no significant difference in RF before operation and 6 months after operation(P>0.05).Conclusion MRI is used for pre-and post-operative examination in patients with CM-SM.It can be confirmed that abnormal cerebrospinal fluid circulation caused by incomplete obstruction of the foramen magnum can form syringomyelia.After surgical treatment,the obstruction of the foramen magnum is r

关 键 词：CHIARI畸形 脊髓空洞 手术 MR 

分 类 号：R744.4[医药卫生—神经病学与精神病学]