CAJ | 학술논문

目的探讨脊髓终室囊样扩张的诊断及治疗经验.方法回顾性分析8例终室囊样扩张患者的临床资料及影像学资料.根据de Moura等建立的临床分类方法,本组2例为Ⅰ型,4例为Ⅱ型,2例为Ⅲ型.6例Ⅱ型和Ⅲ型患者行后正中入路椎板切开术.术中后正中切开圆锥,囊腔内放置T型硅胶管,间断缝合软脊膜并固定T管,保持囊腔与蛛网膜下腔的通畅.结果术后5例患者症状明显改善,1例患者改善不明显,2例保守治疗的患者神经功能状态稳定.结论终室囊样扩张是一种少见的先天性疾病,MRI是首选的检查手段,囊腔-蛛网膜下腔分流术是有效的治疗方法.
목적 탐토척수종실낭양확장적진단급치료경험.방법 회고성분석8례종실낭양확장환자적림상자료급영상학자료.근거de Moura등건립적림상분류방법,본조2례위Ⅰ형,4례위Ⅱ형,2례위Ⅲ형.6례Ⅱ형화Ⅲ형환자행후정중입로추판절개술.술중후정중절개원추,낭강내방치T형규효관,간단봉합연척막병고정T관,보지낭강여주망막하강적통창.결과 술후5례환자증상명현개선,1례환자개선불명현,2례보수치료적환자신경공능상태은정.결론 종실낭양확장시일충소견적선천성질병,MRI시수선적검사수단,낭강-주망막하강분류술시유효적치료방법.
Objective To study the diagnosis and treatment of cystic dilation of ventriculus terminalis (CDVT).Methods The clinical manifestations and MRI characteristics of 8 cases of CDVT treated from Jan.2006 to May.2013 were analyzed.Results There were 6 female and 2 male patients.The mean age of patient was 47.1 years old.The main symptoms were leg pain and spine cord compression.These lesions were spindle shaped,smooth walled,and without internal septae.The cystic contents had the same signal as cerebrospinal fluid on T1 and T2 MRI images,and without contrast enhancement.Two patients with Type Ⅰ (nonspecific complaints) symptoms were treated conservatively.The surgical treatment consisted of dorsolumbar laminotomy,myelotomy,and cyst-subarachnoid shunt placement.In patients with Type Ⅱ (focal neurological deficits) and Ⅲ (sphincter disturbances) symptoms,surgical treatment sustained improvement.Conclusions CDVT is a rare congenital lesion.MRI is the first choice of diagnosis technique.Adequate decompression and cyst-subarachnoid shunt placement are the optimal treatment.Treatment for Type Ⅰ lesion seems to be best conducted conservatively,whereas Types Ⅱ and Ⅲ seem to be best handled surgically.