脊髓栓系综合征40例MRI分析

MRI analysis in 40 cases of tethered cord syndrome

目的:探讨脊髓栓系综合征(TCS)的MRI表现及其诊断价值。方法:对40例患者的MRI影像资料进行分析,并与手术及病理结果相对照。结果:MRI可详细了解脊髓圆锥的位置、终丝、椎管内外脂肪瘤、脊髓脊膜以及脊柱等的各种病理变化。本组可见直接征象脊髓圆锥低位(40/40)、终丝粗大紧张(40/40)、脊髓及马尾粘连(40/40),间接征象腰骶管发育不良(35/40)、脊髓缺血性改变(6/40)、腰骶角增大(22/40)及脊髓空洞(12/40),另可见部分并发征象背部皮毛窦(17/40)、脊髓脊膜膨出(22/40)、椎管内脂肪瘤(28/40)、椎管内囊肿(7/40)、脊柱侧弯畸形(5/40)、椎体畸形(10/40)、脊柱裂(26/40)及脊髓纵裂(1/40)。结论:MRI是脊髓栓系综合征最有效的检查方法,能为脊髓栓系综合征的诊断和手术提供有价值的资料,具有重要的临床意义。

Objective：To investigate the findings and diagnostic value of MRI in tethered cord syndrome（TCS） and to improve the diagnostic level of the disease. Methods： MRI findings and clinical manifestations in 40 patients with surgically proved TCS were analyzed retrospectively. Results：In tiffs study, MRI could delineate the localization of the conus, thickness of the filum terminale and other pathologic conditions. Thick-short filum terminale, diastematomyelia, intradural lipomas, vertebral anomalies and lipomyelomeningoceles were the most common etiological factors. Conus terminalis terminated distal to the level of L2 - L3 intervertebral disc space in all patients. MRI findings were same with the operative findings. Conclusion： MRI was a most effective means for diagnosing TCS and could provide valuable information for diagnosis and operation, MRI was of important significance for TCS.