摘要
目的：探讨脊髓纵裂畸形的分型和ＭＲＩ诊断价值。材料与方法：男１０例，女１４例。年龄６个月至５２岁，１５岁以下者２０例。２４例脊髓纵裂共累及２５段脊髓。均有病变区脊柱Ｘ线平片、平扫ＣＴ和ＭＲＩ。脊髓纵裂分为有隔刺的Ⅰ型和无隔刺的Ⅱ型。Ⅰ型分为有完整隔刺的Ⅰａ型和不完整隔刺的Ⅰｂ型。Ⅱ型分为完全纵裂的Ⅱａ型和不全纵裂的Ⅱｂ型。结果：（１）２５段脊髓纵裂Ⅰ型和Ⅱ型分别占５６％（１４段）和４４％（１１段）。Ⅰａ型占４８％（１２段），Ⅱａ型占３６％（９段），Ⅰｂ和Ⅱｂ型均占８％（２段）；（２）２５段脊髓纵裂Ｘ线平片、平扫ＣＴ和ＭＲＩ诊断阳性率分别为１２％（３段）、６８％（１７段）和１００％（２５段）。（３）２５段脊髓纵裂ＭＲＩ横轴面全部诊断正确，冠状面和矢状面分别诊断２３段和１６段。结论：ＭＲＩ是诊断脊髓纵裂畸形及其椎管内伴发病变最有效的非创伤性方法；对骨性隔刺的显示以ＣＴ为优；横轴面Ｔ１ＷＩ是诊断脊髓纵裂的最佳断面；Ⅰ型脊髓纵裂的隔刺以Ｔ２ＷＩ显示为优；脊髓纵裂分型有助于反映脊髓纵裂的病理形态和指导手术。
Purpose:To explore the classification of diastematomyelia and evaluate the diagnostic value of MRI for diastematomyelia. Materials and methods: Twenty four patients ranged from 6 months to 52 years in age, 10 were males and 14 were females, among which 20 cases were less than 15 years old. There were 25 segments of the spinal cord being involved. All cases were evaluated by roentgenograms of the spine, plain CT and MRI respectively. This entity was divided into two groups: those containing a spur (type Ⅰ) and without (type Ⅱ). Type Ⅰ was subdivided into complete form of the spur (type Ⅰa) and incomplete one (type Ⅰb), while type Ⅱ was subdivided into a complete vertically divided cord (type Ⅱa) and incomplete one (type Ⅱb). Results:(1) Among the 25 segments of diastematomyelia, type Ⅰ accounted for 56% (14/25) and type Ⅱ 44% (11/25), while type Ⅰa was 48% (12/25),type Ⅱa 36% (9/25), type Ⅰb and Ⅱb was 8% (2/25) respectively. (2) The positive rate of roentgenogram, plain CT and MRI for diagnosing diastematomyelia was 12% (3/25), 68% (17/25) and 100% (25/25) respectively. (3) 25 segments of diastematomyelia were all determined with MRI axial section correctly, 23 of them with coronal section and 16 of them with sagittal section. Conclusion:MRI was the most effective method for diagnosing diastematomyelia itself and its intracanal related anomalies, however, the bony spur was better shown on plain CT. Axial section T 1WI was the best orientation for the diagnosis of this entity. The spur of diastematomyelia (type Ⅰ) was shown better on T 2WI. The classification of this entity may benefit the surgeon if operation is feasible, because it provides the true pathological nature of diastematomyelia.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1997年第8期512-515,共4页
Chinese Journal of Radiology
关键词
脊髓疾病
成像
脊髓纵裂
NMR
Spinal cord diseases Abnormalities Magnetic resonance imaging
