Chiari畸形:临床与MRI分析

14例Chiari畸形(CM)包括CM Ⅰ 11例,CM Ⅱ 3例的临床和MRI特征进行了回顾性分析。临床表现与脑干受压、脊髓和小脑病变有关.主要决定于枕大孔的相对性狭窄和脑脊液循环障碍及其程度。78.6％病人可见脊髓空洞症,临床上均有脊髓症状。具有脑干和小脑体征的病人,扁桃体下疝都很显著。MRI是诊断CM的金标准,可无创显示扁桃体疝和脊髓空洞症,并直接探测出颅椎结合部的病理解剖。矢状和冠状面T1加权像最为有效。本文4例进行后颅窝减压和上颈椎板切开收到了显著的效果。

Chiari Malformations;Clinical and MRI Analysis

Clinical and MRI characters of Chiari malformation (CM) in 14 patients included CM I and CM I were retrospectively analyzed. The clinical appearances related to brain stem compression, spinal cord and cerebellum lesions, depended mainly on the degree of the relative obstruction of formaen magnum and of the obstruction of cerebrospinal fluid circulation. Syringomyelia was detected in 78. 6% of patients. Patients who presented with spinal symptoms were proved to have a-syrix on MRI. patients with objective brain stem or cerebellar signs had obviouse tonsillar herniation. MRI is the gold standard in the diagnosis of CM, which demonstrated noninvasively the tonsillar herniation and syringomyelia, and detected directly pathologic anatomy of craniovertebral junction. Sagittal and coronal T1 WI were most informative. Posterior fossa decompression and upper cervical laminectomy were proved to be very more effective in four patients.