相位对比电影MRI及术中超声在Chiari畸形1型手术方式选择中的临床应用进展

Clinical application progress of phase contrast cine magnetic resonance imaging and intraoperative ultrasound in the selection of surgical methods for Chiari malformation type 1

枕大孔减压术是治疗Chiari畸形1型(CM1)患者的通用手术,但减压范围、临床疗效存在争议,没有单一、明确的治疗方法。脑脊液流体动力学的改善可能与临床症状的缓解有关,相位对比电影MRI(PC-MRI)联合术中超声(IOUS)可以准确评估颅颈交界区的脑脊液流体动力学改变,两者结合可以为损害程度评估提供有效信息,指导手术方式的选择,预测临床改善效果,减少再手术的发生。本文对PC-RMI联合IOUS在CM1术式选择中的临床应用进行综述。

Foramen magnum decompression is the shared procedure for Chiari type 1 malformation(CM1).There is no single and clear treatment method,and the scope of decompression and clinical efficacy are controversial.The improvement of cerebrospinal fluid hydrodynamics may be related with the relief of clinical symptoms.The combination of cine phase-contrast magnetic resonance imaging(PC-MRI)and intraoperative ultrasound(IOUS)can accurately assess the cerebrospinal fluid hydrodynamics changes at the cranio-vertebral junction.The combination of these two can provide useful information for the assessment of the degree of damage,guide the selection of surgical methods,predict clinical improvement effect,and reduce reoperation rate.This article reviews the clinical application of PC-MRI combined with IOUS in the selection of CM1 surgical procedures.