小儿先天性神经管闭合不全的MRI诊断分析

MRI diagnosis of congenital spinal dysraphism in children

目的探讨分析小儿先天性神经管闭合不全的MRI特征及临床表现,提高对该疾病的诊断能力。方法回顾性分析经手术病理或随访证实21例神经管闭合不全病儿的临床和影像学资料。结果 21例神经管闭合不全病儿MRI上多合并畸形改变,主要表现为脊髓脊膜膨出7例,脊膜膨出6例,脂肪型脊髓脊膜膨出8例,其中合并脊髓拴系综合征11例,脊髓纵裂2例,脊髓空洞积水2例,椎管内脂肪瘤4例,髓外硬膜内囊肿1例;伴发其他畸形4例。MRI诊断与手术病理或随访诊断符合率为90.5%(19/21)。结论 MRI可以对先天性神经管闭合不全进行良好的定位及定性诊断,具有较大临床应用价值。

Objective To explore and analyze the MRI characteristics and clinical manifestations of congenital spinal dysraphism in children, and improve the diagnostic ability for the disease. Methods Clinical and imaging data of 21 children with congenital spinal dysraphism were analyzed retrospectively, who were confirmed by surgical pathology or follow-up results. Results The MRI results of 21 children with congenital spinal dysraphism mostly showed combined malformations including myelomeningocele in 7 patients,meningocele in 6, lipomyelomeningocele in 8, tethered cord syndrome in 11, diastematomyelia in 2, syringohydromyelia in 2,intraspinal lipoma in 4, intradural extramedullary cyst in 1 and combined with other malformations in 4. The diagnostic coincidence rate between MRI and surgical pathology or follow-up results was 90.5%（19/21）. Conclusion MRI has a good localization diagnosis and qualitative diagnosis function for congenital spinal dysraphism, and is of great value for clinical application.