磁共振成像在儿童脊髓栓系综合征诊断和评价中的作用

THE DIAGNOSIS AND EVALUATION OF MRI IN THE TETHERED CORD SYNDROME OF CHILDREN

目的 :分析探讨MR在儿童脊髓栓系综合征 (TCS)诊断和评价中的作用。方法 :回顾性分析 2 1例TCS患儿的临床和MR资料 ,MRI检查采用矢状位T1、T2加权和轴位T1加权成像 ,部分加做冠状位T1加权成像 ;对每例患者的脊髓圆锥水平、终丝粗细、脊柱脊髓改变和并存的其它异常进行分析总结。结果 :2 1例中 2 0例脊髓圆锥低于腰 1～ 2椎间平面 (测量 17例患者的终丝 ,15例可见增粗 ) ;7例脊髓可见空洞或软化样改变 (19例可见有脊柱异常 )。造成脊髓栓系的原因包括椎管脂肪瘤 11例 ,脊髓纵裂 4例 ,脊膜膨出 2例 ,脊膜脊髓膨出并脂肪瘤 4例。结论 :MR能够清晰显示TCS的病因 ,以及并存的脊柱脊髓先天异常和继发的脊髓改变 ,是确诊TCS的首选检查方法 ,对TCS的术后随访评价具有重要的价值。

Objective:To analysis and discuss the value of MRI in the diagnosis,typing and evaluation of TCS on children.Methods:The clinical and MRI data of 21 children with TCS were analysed retrospectively.All children were examined with sagittal T1 weighted and T2 weighted imaging using 1 0Tsuper conducted MR machine.The cornus level,diameter of filum terminale and other abnormalities were analysed.Results:Toinzl children with cornus below L1-2 space level.7 children with focal syringhydromyelic or myelomalacia.The tethered cause included:spinal lipoma 11 cases,diastematomyelia in 4 cases.Myelomeningocele with lipoma in 4 children,Meningocele 2 cases.Conclusions:The cause of TCS,abnormality of spinal colum and spinal cord were clearly showed on MR imaging.MR imaging is the preferred method in the diagnosis of TCS.It has great values in the following evaluation of postoperated TCS.