| 张德清,马娟,程英,姜春晖,田硕,胡云方,万志方,孟志华.颅底脊髓出口影响ChiariⅠ畸形脊髓空洞形成的MRI分析[J].中国医学影像技术,2017,33(7):975~979 |
| 颅底脊髓出口影响ChiariⅠ畸形脊髓空洞形成的MRI分析 |
| MRI analysis of spinal cord outlet of skull base on formation of syringomyelia in Chiari Ⅰ malformation |
| 投稿时间：2016-12-07 修订日期：2017-02-28 |
| DOI：10.13929/j.1003-3289.201612029 |
| 中文关键词: Arnold-Chiari畸形 脊髓空洞症 磁共振成像 |
| 英文关键词:Arnold-Chiari malformation Syringomyelia Magnetic resonance imaging |
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| 中文摘要: |
| 目的 探讨颅底脊髓出口对Chiari I畸形合并脊髓空洞形成的影响。方法 测量294例Chiari Ⅰ畸形脑干—颈髓角（Anbc）、斜坡—颈椎角（Ansc）；在枕骨大孔（Llf）、寰椎前上缘（Laf）层面测量椎管（Ac）、脊髓（As）、下疝体面积（Ah）及下疝体长度（Lh）；比较Chiari Ⅰ畸形无脊髓空洞（无脊髓空洞组）、合并脊髓空洞（合并脊髓空洞组）及正常对照组的各角度、面积及其比值、差值。结果 合并脊髓空洞组、无脊髓空洞组和对照组Ansc、Anbc－Ansc值比较总体差异有统计学意义（P均<0.001），两两比较差异均有统计学意义（P均<0.05）；3组Anbc比较总体差异无统计学意义（P>0.05）。在Llf、Laf层面上，3组As差异有统计学意义（P均<0.05），Llf层面合并脊髓空洞组与对照组、无脊髓空洞组与对照组差异均有统计学意义（P均<0.05）。Laf层面合并脊髓空洞组Ac均小于对照组和无脊髓空洞组（P均<0.05）。Llf、Laf层面Ah、Llf层面Lh在合并脊髓空洞组与无脊髓空洞组比较差异均无统计学意义（P均>0.05）。Llf、Laf层面3组As/Ac比较差异有统计学意义（P均<0.001），两两比较显示，Llf层面合并脊髓空洞组与对照组差异有统计学意义（P<0.05）；Laf上，合并脊髓空洞组与对照组、无脊髓空洞组与对照组差异有统计学意义（P均<0.05）。结论 Ansc减小、脊髓出口狭小、脊髓椎管占比增大是促进Chiari I畸形脊髓空洞发生的重要因素。 |
| 英文摘要: |
| Objective To investigate the mechanism and effect of the spinal cord outlet of the skull base on Chiari Ⅰ malformation with syringomyelia. Methods The cervical spinal cord stem angle (Anbc), slope angle of cervical vertebra (Ansc) of Chiari Ⅰ malformation were measured. In foramen magnum (Llf) and anterior vertebral canal level (Laf), spinal canal(Ac), spinal cord (As) and inferior hernia area (Ah) were measured. Angle, area and ratio were compared in Chiari Ⅰ malformation with syringomyelia, Chiari Ⅰ malformation without syringomyelia and normal control group. Results Ansc, Anbc—An sc had significant differences among control group and Chiari Ⅰ malformation patients (all P<0.001). In Llf, Laf, As had significant differences among three groups (all P<0.05), further comparison of the two showed there were significant differences between Chiari Ⅰ malformation with syringomyelia patients and control group, Chiari Ⅰ malformation without syringomyelia patients and control group in Llf (all P<0.05). In Llf, Laf, Ac in Chiari Ⅰ malformation with syringomyelia was smaller than control group (P<0.05). Ah in Llf, Laf and Lh in Llf had no statistical significant difference between Chiari Ⅰ malformation with and without syringomyelia patients (all P>0.05). In Llf, Laf, As/Ac had statistical significant difference among Chiari Ⅰ malformation with and without syringomyelia patients, control group (all P<0.001), further comparison of the two showed As/Ac in Llf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group (P<0.05), As/Ac in Laf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group, between Chiari Ⅰ malformation without syringomyelia patients and control group (all P<0.05). Conclusion The cervical spinal cord, Ansc reducing, narrow vertebral proportion increase are important factors to promote Chiari I malformation syringomyelia. |
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