CAJ | 학술논문

目的探讨CT脊髓造影在自发性颅内低压脑脊液漏点检出中的价值及影像学表现.方法 6例自发性颅内低压患者,男女各3例,均符合2004年国际头痛分类第2版自发性颅内低压的诊断标准.影像学资料包括5例全脊柱MRI检查和6例全脊柱CT脊髓造影.根据CT脊髓造影发现的脑脊液漏点,选择穿刺部位,透视下注射混合碘造影剂的自体静脉血,随访观察治疗效果.结果 5例全脊柱MRI检查均未发现漏点.6例CT脊髓造影检查均发现了漏点,各例漏点数目为1～7个,总漏点数目25个,平均4.2个,其中颈椎和胸椎各12个,腰椎1个.CT脊髓造影表现包括造影剂线状漏出、椎旁软组织内片状造影剂蓄积及神经根袖呈鸟嘴样扩大等.6例患者经靶向硬膜外血贴治疗后获得临床痊愈.结论 CT脊髓造影是一种有效和精确的自发性脊髓脑脊液漏点定位诊断手段.
목적 탐토CT척수조영재자발성로내저압뇌척액루점검출중적개치급영상학표현.방법 6례자발성로내저압환자,남녀각3례,균부합2004년국제두통분류제2판자발성로내저압적진단표준.영상학자료포괄5례전척주MRI검사화6례전척주CT척수조영.근거CT척수조영발현적뇌척액루점,선택천자부위,투시하주사혼합전조영제적자체정맥혈,수방관찰치료효과.결과 5례전척주MRI검사균미발현루점.6례CT척수조영검사균발현료루점,각례루점수목위1～7개,총루점수목25개,평균4.2개,기중경추화흉추각12개,요추1개.CT척수조영표현포괄조영제선상루출、추방연조직내편상조영제축적급신경근수정조취양확대등.6례환자경파향경막외혈첩치료후획득림상전유.결론 CT척수조영시일충유효화정학적자발성척수뇌척액루점정위진단수단.
Objective To evaluate the application of CT myelography (CTM) in detecting the site of spontaneous cerebrospinal fluid (CSF) leaks and analyze it's imaging features.Methods Six patients (3 women and 3 men) with spontaneous intracranial hypotension (SIH) were included, who met the criteria of the International Headache Classification (2nd edition, 2004). Five patients subsequently underwent whole spine MRI and all 6 patients underwent CTM. Autologous blood mixed with omnipaque (300 mg/ml) was injected followed by selective puncture at the leak site indicated by CTM. Results MRI was failed to find leak site in the 5 patients, whereas CTM successfully found leak sites in all 6 patients. There were 1 to 7 leak sites respectively with an average of 4.2 sites (totally 25 points). Leak sites at cervical (12 sites) and thoracic (12 sites) were more frequent than at lumbar (1 site). CTM was featured by linear leakage of the contrast medium along the spinal nerve roots, paraspinal collections of hyper-density contrast medium and beak-like enlargement of the nerve sleeves. All patients responded well to the treatment, with complete resolution of symptoms. Conclusion CTM has been shown to be a study of choice to accurately define the location and extent of a CSF leak.