骶管硬膜外蛛网膜囊肿的诊断及手术治疗

①目的探讨骶管硬膜外蛛网膜囊肿的诊断及治疗方法。②方法回顾分析36例经手术证实的骶管硬膜外蛛网膜囊肿病人的影像学资料，分析其临床特点及术中的病理特点。③结果骶管硬膜外蛛网膜囊肿临床症状以骶管内神经受压表现为主，囊肿与硬膜囊一般有交通孔。X线检查示骶骨骨质侵蚀9例，有腰骶部先天畸形5例；CT显示骶骨侵蚀性改变及骶管内囊肿11例；MRI示硬膜囊末端均为梭形的囊性肿物，与脑脊液信号相同。本组病人均采取手术治疗，其中31例得到6～149个月的随访，平均36．6个月，29例病人疗效优良。④结论MRI是骶管硬膜外蛛网膜囊肿最好的影像学诊断方法。神经症状重、影像学显示囊肿大者应手术治疗。

DIAGNOSIS AND SURGERY OF ARACHNOID CYSTS IN SACRAL CANAL

Objective To study the diagnosis and the treatment of arachnoid cysts in the sacral canal. Methods Thirty-six patients with arachnoid cysts treated were analyzed retrospectively. The radiological changes including X-ray, CT and MRI, as well as their clinical behaviors, and the methods of operation were evaluated. Results Clinical symptoms were caused by compression of sacral nerves. There were communicating holes between arachnoid cysts and thecal sacs. Bone erosion sometimes observed in X-ray, but often in CT and MRI. The cyst could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. All the patients underwent operation, in which, 31 patients were followed up from six to 149 months. An excellent result achieved in 29 patients. Conclusion MRI is the best imaging method in the diagnosis. Patients with compression of sacral nerves should be treated surgically.