动态MRI扫描与Chiari畸形下疝程度的相关性分析  

Dynamic MRI Scanning and Hernia Degree in Chiari Malformation:a Correlation Analysis

作　　者：周伟 洪欣[1] ZHOU Wei;HONG Xin(Department of Medical Imaging,the First People’s Hospital of Fuzhou City,Fuzhou 344000,China)

机构地区：[1]抚州市第一人民医院影像科,江西抚州344000

出　　处：《实用临床医学（江西）》2024年第6期64-66,F0004,共4页Practical Clinical Medicine

摘　　要：目的观察动态MRI扫描中Chiari畸形下疝程度的变化,评估体位变化对下疝程度的影响。方法选取2021年3月至2024年3月江西省抚州市第一人民医院收治的Chiari畸形患者45例作为研究对象,采用MRI颈部专用线圈对患者进行动态MRI扫描(过屈位、过伸位和标准位),序列为矢状面和横轴面,分别于过屈位、过伸位和标准位下测量小脑疝出的数值,并采取正中层面、右旁正中层面、左旁正中层面进行多次测量。结果正中层面小脑下疝程度仍以标准位位所测值为最大,过屈位其次,过伸位最小;右旁正中层面、左旁正中层面所测小脑下疝程度正侧位与过屈位相近,过伸位最小;正中层面、左旁正中层面、右旁正中层面所测小脑下疝程度过屈位均优于过伸位。40岁及以上的30例中老年患者中,正中面过屈位检出的小脑下疝的程度明显大于标准位(P=0.049)。结论动态MRI扫描能够有效反映不同体位下小脑扁桃体下疝程度的变化,过屈位测量在多数情况下优于过伸位。Objective To observe the changes of hernia degree in Chiari malformation during dynamic MRI scanning and evaluate the impact of positional changes on hernia degree.Methods 45 patients with Chiari malformation admitted to the First People’s Hospital of Fuzhou City,Jiangxi Province from March 2021 to March 2024 were selected as the study subjects.Dynamic MRI scanning(hyperflexion,hyperextension,and standard positions)was performed on the patients using a dedicated MRI neck coil.Sagittal and transverse axial sequences were used,and the values of cerebellar herniation were measured in the hyperflexion,hyperextension,and standard positions.Multiple measurements were taken at the median,right paramedian,and left paramedian levels.Results In the median level,the value of cerebellar herniation was greatest in the standard position,followed by the hyperflexion position,and smallest in the hyperextension position;in both the right and left paramedian levels,the degree of cerebellar herniation measured in the hyperflexion position was similar to that in the standard position,while it was smallest in the hyperextension position;in all three levels(median,right paramedian,and left paramedian),the degree of cerebellar herniation measured in the hyperflexion position was greater than that in the hyperextension position.Among the 30 middle-aged and elderly patients aged 40 and above,the degree of cerebellar herniation detected in the hyperflexion position at the median level was significantly greater than that in the standard position(P=0.049).Conclusion Dynamic MRI scanning can effectively reflect changes in the degree of cerebellar tonsillar herniation in different positions,and hyperflexion measurement is potentially superior to hyperextension measurement in most cases.

关 键 词：CHIARI畸形 小脑下疝程度 正中层面 旁正中层面 动态MR扫描 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.89[医药卫生—诊断学]