CAJ | 학술논문

目的评估青少年特发性脊髓空洞(idiopathic syringomyelia,IS)患儿后颅窝线性容积,并探讨其临床意义.方法从2008年1月至2011年10月我院诊断为IS的病例中选择影像学资料完整的青少年患儿25例(IS组).同时选取性别、年龄匹配的继发于Chiari畸形Ⅰ型的脊髓空洞(Chiari malformation type Ⅰ& syringomyelia,CMI-S)患儿(CMI-S组)及正常青少年作为对照组.在正中矢状面MR影像上分别测量三组患儿后颅窝线性容积的距离指标(后颅窝斜坡长度、枕骨大孔径、枕上长度、后颅窝矢状径、后颅窝高径)和角度指标(后颅窝斜坡倾斜角),并运用单向方差分析统计三组患儿后颅窝各测量指标间的差异.结果 IS组后颅窝斜坡长度25.4～48.7 mm(平均38.3 mm);枕骨大孔前后径27.2～44.2 mm(平均33.6 mm);枕骨鳞部长度23.6～48.2 mm(平均36.7 mm);后颅窝矢状62.9～88.4 mm(平均74.3 mm);后颅窝高径18.5～43.9 mm(平均31.3 mm)及斜坡倾斜角30.0°～77.0°(平均56.7°).IS组与CMI-S组患儿的后颅窝线性容积各测量指标均显著小于正常青少年,差异有统计学意义(P＜0.05).IS组患儿后颅窝斜坡倾斜角为56.7°±10.6°,显著大于CMI-S组患儿50.8°±11.7°,差异有统计学意义(P＜0.05),其余指标差异没有统计学意义(P＞0.05).结论 IS患儿与CMI-S患儿均存在后颅窝骨性结构的发育异常.与CMI-S患儿相比,IS患儿具有较为陡直的斜坡结构.
목적 평고청소년특발성척수공동(idiopathic syringomyelia,IS)환인후로와선성용적,병탐토기림상의의.방법 종2008년1월지2011년10월아원진단위IS적병례중선택영상학자료완정적청소년환인25례(IS조).동시선취성별、년령필배적계발우Chiari기형Ⅰ형적척수공동(Chiari malformation type Ⅰ& syringomyelia,CMI-S)환인(CMI-S조)급정상청소년작위대조조.재정중시상면MR영상상분별측량삼조환인후로와선성용적적거리지표(후로와사파장도、침골대공경、침상장도、후로와시상경、후로와고경)화각도지표(후로와사파경사각),병운용단향방차분석통계삼조환인후로와각측량지표간적차이.결과 IS조후로와사파장도25.4～48.7 mm(평균38.3 mm);침골대공전후경27.2～44.2 mm(평균33.6 mm);침골린부장도23.6～48.2 mm(평균36.7 mm);후로와시상62.9～88.4 mm(평균74.3 mm);후로와고경18.5～43.9 mm(평균31.3 mm)급사파경사각30.0°～77.0°(평균56.7°).IS조여CMI-S조환인적후로와선성용적각측량지표균현저소우정상청소년,차이유통계학의의(P＜0.05).IS조환인후로와사파경사각위56.7°±10.6°,현저대우CMI-S조환인50.8°±11.7°,차이유통계학의의(P＜0.05),기여지표차이몰유통계학의의(P＞0.05).결론 IS환인여CMI-S환인균존재후로와골성결구적발육이상.여CMI-S환인상비,IS환인구유교위두직적사파결구.
Objective To investigate the morphometric characteristics of the posterior fossa in adolescents with idiopathic syringomyelia (IS) and to elucidate the clinical significances.Methods A retrospective radiographic review was performed on 25 adolescents who were diagnosed as IS and treated at our clinic between January 2008 and October 2011.Another cohort of normal adolescents and chiari malformation type Ⅰ & syringomyelia(CMI-S) patients,matched with the IS patients in age and gender,were recruited as the control group.Six parameters were assessed in mid-sagittal MR images,including the linear parameters (the length of the clivus,the anteroposterior diameter of the foramen magnum,the length of supraocciput,the anteroposterior diameter of the posterior fossa,the posterior fossa height) and the angular parameter (the clivus gradient).Results In the IS group,the length of the clivus ranged from 25.4 mm to 48.7 mm (mean 38.3 mm) ; the anteroposterior diameter of the foramen magnum ranged from 27.2 mm to 44.2 mm (mean 33.6 mm); the length of supraocciput ranged from 23.6 mm to 48.2 mm (mean 36.7 mm),the anteroposterior diameter of the posterior fossa ranged from 62.9 rmm to 88.4 mm (mean 74.3 mm),the posterior fossa height ranged from 18.51 mm to 43.9 mm (mean 31.3 mm) and the clivus gradient ranged from 30.0 to 77.0 (mean 56.7).Significant differences were observed in all the six morphometric parameters when comparing the IS group and CMI-S group with the normal group respectively.Additionally,all parameters were similar between the IS and CMI-S groups except for the clivus gradient which was significantly larger in the IS group (56.69 ± 10.6,P＜0.05).Conclusions The posterior fossa in patients with IS,sharing the similar characteristics with these in patients with CMI-S,is indeed smaller than normal.A steeper clivus is observed in patients with IS when compared with that in patients with CMI-S.