脊髓栓系综合症的CT、MRI研究

The Study of Tethered Cord Syndrome with CT and MRI

目的 探讨脊髓栓系综合症 (TCS)CT和MRI特点及诊断价值。材料与方法 回顾性分析TCS 3 2例 ,对其CT及MRI表现、临床特点和相关资料进行对照分析。结果 3 2例中 ,脊髓低位 2 6例 ,脊髓位置正常 6例。低位脊髓合并脊髓纵裂 5例 ,双干脊髓 6例 ,椎管内脂肪瘤 10例 ,椎管内皮样囊肿 3例 ,脊髓空洞症 5例 ,脂肪脊髓膨出 7例 ,半锥体 3例 ,椎板缺如 3例 ,棘突分叉畸形 8例。脊髓位置正常合并双干脊髓 3例。脊髓空洞症 1例 ,脊髓纵裂 1例。结论 MRI对明确诊断TCS具有重要价值 ,能明确显示脊髓圆锥的位置、形态及伴发畸形 ;而CT对诊断TCS有局限性 ,对MRI诊断起补充作用。

Objective To discuss CT and MRI features of tethered cord syndrome (TCS), and their diagnostic value.Materials and Methods CT and MRI findings, and clinical data and features in 32 cases with TCS were retrospectively compared and analyzed.Results Spinal cord was terminated below L 1～L 2 in 26 cases, and was in normal position in 6 cases. Findings in patients with lower positioned spinal cord were as follows: diastematomyelia (n=5), double stem spinal cord (n=6), intradural lipoma (n=10), intradural epidoma (n=3), syringomyelia (n=5), meningocele (n=7), hemivertebrae (n=5), laminar defects (n=3), and bifid vertebrae (n=9). In patients with normally positioned spinal cord the following abnormalities were seen: diastematomyelia (n=1), double stem spinal cord (n=3), intradural lipoma (n=1), intra dural epidoma (n=1), syringomyelia (n=1), laminar defects (n=1), and bifid vertebrae (n=2).Conclusion MRI can clearly demonstrate the position and shape of the spinal cord conus, as well as the associated malformations, and, thus, it is of great value in diagnosing TCS. CT can still be served as a supplement to MRI although it has limited value in diagnosing TCS.