脊髓纵裂128例影像学表现与神经症状的相关性_医学论文.docVIP

脊髓纵裂128例影像学表现与神经症状的相关性_医学论文 脊髓纵裂128例影像学表现与神经症状的相关性_医学论文 作者：李永甫，兰宾尚，同高峰，张纯，樊李瀛 【摘要】 　　目的： 探讨脊髓纵裂（DM）影像学与临床神经症状的关系. 方法： 对我院1975收治的128例DM患者对其影像学特征、临床神经症状及随访情况进行回顾分析和总结. 结果： 双管型98例，影像学表现为脊髓纵裂不对称、有间隔、位于胸腰段及腰段、合并脊髓水囊肿大，出现临床神经功能症状重；单管型30例，影像学表现为脊髓纵裂对称性分布、无间隔或稍有纤维性间隔、位于颈段及颈胸段、合并脊髓水囊肿小，出现临床神经功能症状轻，两者均与病变部位脊髓纵裂长度无明显关系. 结论： DM的影像学表现与临床神经症状关系密切，治疗应根据DM分型、影像学特征和神经症状综合考虑. 【关键词】 脊髓纵裂；影像学表现；神经病学表现 　　【Abstract】AIM: To analyze the relationship between imaging features and clinical nervous symptoms of diastematomyelia(DM). METHODS: The imaging features, clinical nervous symptoms and prognosis of 128 DM patients with complete data in our hospital from May,1975 to January, 2007 were analyzed retrospectively. RESULTS: Imaging features including the asymmetry, existence of septum, location in thoracic waist and lumber segments and large combined hydrocyst were displayed in 98 cases of doubletube DM, who suffered serious clinical nervous symptoms. Imaging features including the symmetry, inexistence of septum or having some fiber septum, location in cervical and cervicalthoracic segments and small combined hydrocyst were found in 30 cases of singletube DM, who suffered mild clinical nervous symptoms. In addition, both had no clear relation to the length of spinal cord division. CONCLUSION: There are close relations between imaging features and clinical nervous symptoms in DM patients. Then the typing, the imaging features and the clinical never symptoms should all be taken into consideration for the treatment. 　　【Keywords】 diastematomyelia imaging neurologic manifestations 　　0 引言 　　脊髓纵裂（diastematomyelia, DM）是一种少见的神经管闭合不全所产生的先天性畸形,是由于胚胎发育畸形而产生脊髓和/或马尾被骨性、软骨性或纤维性中隔矢状分开,而出现神经异常，常并发其它畸形等临床症状.近年来,随着影像学科的迅猛发展及临床诊疗水平的不断提高,对该病的诊断与治疗有了更清楚的认识,国内外对该病的报道也呈增加趋势.现对我院有影像学及临床资料的128病例进行统计分析,以探讨DM影像学与临床神经症状的关系. 　　1 对象和方法 　　1.1 对象 　　1975收治的DM128（男45，女83）例，年龄2月~58(平均15.7)岁. 分为两型［1］: ① 双管型98例,平均年龄4岁,其特征是病变区硬膜管为两独立的次管,其内有各自分裂的半脊髓 ② 单管型30例,平均年龄26.5岁,病变区硬膜管呈单管扩大,其内包含两“镜影状”分裂脊髓. DM的主要临床表现为： ① 背部皮肤特征性改变,