MRI测量颈髓延髓角对颅底凹陷症的术前诊断及术后评估价值

目的：通过测量对比颅底凹陷症患者术前、术后以及正常人群颈髓延髓角的大小，探讨颈髓延髓角对颅底凹陷症患者术前诊断及术后评估价值。方法搜集我院2005年1月～2013年1月明确诊断并手术的颅底凹陷症患者63例，以及同期行M RI检查显示无颅颈结合部病变者40例，测量并比较颅底凹陷症患者术前、术后及对照组颈髓延髓角的大小。结果63例颅底凹陷症中有42例行术前及术后M RI检查，21例仅行术前M RI检查，63例颅底凹陷症患者术前平均颈髓延髓角为（138．0±11．2）°，42例术后平均颈髓延髓角为（156．3±8．7），40例正常对照组明确平均颈髓延髓角为（154．9±7．7）°，颅底凹陷症患者术前颈髓延髓角明显小于正常对照组及术后患者， P ＜0．05，术后患者颈髓延髓角与正常对照组无显著性差异， P ＞0．05。结论颈髓延髓角可以作为诊断颅底凹陷症及术后评估的重要指标。

Preoperative diagnosis and postoperative evaluation value of cervico-medullary angle measurements on MRI in patients with basilar invagination

Objective To investigate the preoperative diagnosis and postoperative evaluation value of cervico-medullary angle measured on MRI patients with basilar invagination by comparing those among patients before and after operation and normal controls .Methods Sixty-three basilar invagination cases diagnosed and operated in our hospital from Jan 2005 to Jan 2013 and 40 normal controls with no craniovertebral junction abnormalities in the same period were collected ,the cervico-medullary angles were measured and compared in patients before and after operation and normal controls .Results Among the 63 cases of basilar invagination ,42 cases underwent preoperative and postoperative MRI examinations ,the other 21 patients only had preoperative scans .The mean preoperative CMA of 63 patients was （138 .0 ± 11 .2）° ,the mean postoperative CMA of 42 patients was （156 .3 ± 8 .7）°; ,and the mean CMA of 40 normal controls was （154 .9 ± 7 .7）° .The mean preoperative CMA was smaller than postoperative and normal control values ,P 〈0 .05 ,but the latter two had no significant difference ,P〉0 .05 .Conclusion CM A can be an important index for diagnosis and postoperative evaluation of basilar invagination .