椎管内肠源性囊肿的临床分析及磁共振表现

Clinical features and MRI manifestations of intraspinal enterogenous cysts

目的:探讨椎管内肠源性囊肿的临床特点和磁共振成像(magnetic resonance imaging MRI)特征,提高对本病的认识及诊断水平.方法:检索中国知网数据库和万方数据资源系统有关椎管内肠源性囊肿的个案报道,根据纳入排除标准进行筛选和纳入,总结分析椎管内肠源性囊肿的临床及MRI特点.结果:共纳入60篇文献80例患者,男女比为46:33,平均年龄19.9岁±14.6岁,平均病程2.87岁±5.00年;37.50%患者以颈肩背部疼痛或不适为主诉或首发症状,82.50%患者出现运动功能障碍,13例患者有合并症;部位多位于颈髓(45.00%)、脊髓腹侧(83.33%)、硬膜下(94.87%),MRI检查T1加权像(T1weighted imaging,T1WI)信号多为低信号(67.35%),T2加权像(T2 weighted imaging T2W I)信号多为高信号(91.84%),增强多无强化,相应脊髓段受压变细、变薄及移位所有患者行手术治疗,95.74%患者术后恢复良好,3例复发.结论:肠源性囊肿是一种少见的先天性病根据临床表现结合MRI特点可及时进行早期诊断及治疗.MRI检查为其术前定位定性诊断、制定手术方案及判断预后等提供重要依据.

AIM： To explore the clinical features and magneticresonance imaging （MRI） manifestations of intraspinal enterogenous cysts. METHODS： Case reports concerning intraspinal enterogenous cysts were retrieved from CNKI and WanFang Data and screened according to the inclusion and exclusion criteria. The clinical features and MRI manifestations of intraspinal enterogenous cysts were analyzed. RESULTS： A total of 60 case reports with 80 patients were included. The male to female ratio was 46：33. The mean age was 19.9 years ± 14.6 years. The mean course of disease was 2.87 years± 5.00 years. There were 37.50% of patients with chief complaint or first symptom of neck- shoulder-back pain or discomfort. Most of the patients （82.50%） had motor dysfunction, and 13 patients had complications. The lesions were mostly located in the cervical （45.00%）, ventral （83.33%） and subdural （94.87%） spinal cord. The signal was mostly hypointensity （67.35%） on T1 weighted imaging and hyperintensity （91.84%） on T2 weighted imaging in MRI examination. No enhancement was observed in most post- contrast images. Thinning and displacement can be observed in the corresponding spinal segments due to compression of cysts. All patients underwent surgery, and 95.74% of them recovered well. There were three cases of CONCLUSION： Intraspinal enterogenous cyst is a rare congenital disease. It can be diagnosed early and treated timely based on the clinical features and MRI manifestations. MRI examination provides an important tool for preoperative diagnosis, surgical planning and prognosis evaluation of intraspinal enterogenous cysts.