青少年伴/不伴Arnold-Chiari畸形的脊髓空洞的影像学特征比较

Comparison of radiological features between Arnold-Chiari malformation-associated syringomyelia and idiopathic syringomyelia in adolescent

目的探讨继发于Arnold-Chiari畸形的脊髓空洞（Arnold-Chiari malformation-associated syringomyelia,ACMS）与特发性脊髓空洞（idiopathic syringomyelia,IS）之间影像学特征的差异及其临床意义。方法对2006年6月~2013年6月在本院接受治疗并符合入选标准的132例（男70例,女62例）ACMS患儿及46例（男24例,女22例）IS患儿进行回顾性分析。在全脊髓MRI图像上评估2组患儿空洞的形态学特征,包括空洞与脊髓最大比值、空洞长度、空洞位置及形态。结果 ACMS组空洞与脊髓最大比值为0.61±0.18,空洞长度为9.01±4.88（2~20）个节段,均显著大于IS组（0.43±0.14,4.09±2.07）,差异有统计学意义（P〈0.05）。ACMS组中82.57%空洞累及颈胸段,而IS组中50.00%空洞仅累及颈段。ACMS组中43.94%为膨胀型,而IS组中78.26%为局限型,差异有统计学意义（P〈0.05）。结论与IS相比,ACMS的空洞与脊髓最大比值更大,累及节段更长。

Objective To investigate whether different radiological characteristics exist between Arnold-Chiari malformation-associated syringomyelia（ ACMS） and idiopathic syringomyelia（ IS） and to elucidate its clinical significances.Methods All cases with syringomyelia treated between June 2006 and June 2013 were identified and retrospectively reviewed.Based on the inclusion criteria,178 cases including 132 with ACMS（ 70 males and 62 females） and 46 with IS（ 24 males and 22 females） were finally enrolled for the study.The following parameters measured on preoperative MRI were compared between the 2 groups：maximal value of syrinx / cord（ S / C）,syrinx length,syrinx level and the configuration of syrinx.Results Both the maximal value of S / C and the syrinx length were found to be significantly larger in ACMS group than in IS group（ 0.61 ± 0.18 versus 0.43 ± 0.14,9.01 ± 4.88 versus 4.09 ± 2.07;P〈0.05）.Concerning the location of syrinx,the cervicothoracic spinal cord was involved in 82.57% of syringes in ACSM group,whereas 50.00% of syringes in IS group were confined to the cervical level.The difference was statistically significant（ P〈0.05）.Specifically,distended type was found in 43.94% of the syringes in ACSM group,whereas 78.26% was categorized into the circumscribed type in IS group.The difference was statistically significant（ P〈0.05）.Conclusions Compared with IS,larger maximal value of S / C and longer syrinx length are found in ACMS.