CAJ | 학술논문

目的运用磁共振对ChiariⅠ畸形病例进行后颅窝形态学测量。方法在颅脑正中矢状面上分别对50例ChiariⅠ畸形患者及50例不伴有中枢神经系统疾患者的后颅窝骨性及神经结构进行测量。结果 Chiaari Ⅰ畸形组的后颅骨性结构及颅腔大小小于对照组(P＜0.01)；后颅窝及枕大孔区的脑脊液间隙变窄(P＜0.01)；颅腔形态两组间亦有显著差异(P＜0.01)；畸形组后脑位置下移，但后脑大小两组间无显著性差异(P＜0.05)。结论 ChiariⅠ畸形的发病机制可能为后颅骨发育不良导致后颅过度拥挤，使小脑扁桃体向下疝入椎管。
목적운용자공진대ChiariⅠ기형병례진행후로와형태학측량。방법재로뇌정중시상면상분별대50례ChiariⅠ기형환자급50례불반유중추신경계통질환자적후로와골성급신경결구진행측량。결과 Chiaari Ⅰ기형조적후로골성결구급로강대소소우대조조(P＜0.01)；후로와급침대공구적뇌척액간극변착(P＜0.01)；로강형태량조간역유현저차이(P＜0.01)；기형조후뇌위치하이，단후뇌대소량조간무현저성차이(P＜0.05)。결론 ChiariⅠ기형적발병궤제가능위후로골발육불량도치후로과도옹제，사소뇌편도체향하산입추관。
Objective To determine the morphological chane and pathogenesis of malformation Chiari Ⅰ by measuring the posterior cranical fossa structures. Method The posterior cranial fossa structures on mid - sagittal MR image were measured in 50 patients with malformation Chiari Ⅰ and 50 controls without disease of central nervous system. The t - test was used for statistical analysis. Result The cranical cavity and CSF space in posterior fossa malformation with Chiari Ⅰ was significantly smaller than that of control group, the hindbrain position was significantly lower than control group. There was significant difference in the morhpology of posterior cranial fossa and no significant difference in the size of hindbrain between the two groups. Conclusion The narrow posterior cranical cavity, downward displacement of hindbrain, deformed cerebellar tonsilis displaced downward below foramen magnum, and narrow CSF space in the foramen magnum region is the main morphological change of Chiari Ⅰ malformation. In malformation Chiari Ⅰ, the underdeveloped occipital bone indues overcrowding in the posterior fossa, result in the cerebellar tonsilis displaced downwards foramen magnum.