成人单纯Arnold-Chiari畸形颅颈交界区CT参数测量

目的探讨不合并颅底凹陷的单纯Arnold-Chiari畸形(Arnold-Chiari malformation,ACM)颅颈交界区CT参数的变化。方法对40例成人单纯ACM和20例正常成人对照组头颈CT原始数据行正中矢状位重建,研究颅颈交界区CT线性及角度参数的变化。结果单纯ACM患者的斜坡长[(40.66±3.11)mm vs(43.44±3.34)mm,P<0.01]、齿突Chamberlain线间距[(1.23±2.41)mm vs.(1.25±2.29)mm,P<(0.001)]、齿突McRae线间距[(4.04±1.39)mm vs.(4.95±1.29)mm,P(<0.05)]、斜坡椎管角(147.93°±7.84°vs.157.33°±8.51°,P<0.001)、减压枕骨角(139.11°±10.14°vs.144.49°±8.03°,P<0.05)明显小于对照组,而斜坡McRae线角(130.82°±7.85°vs.124.60°±7.35°,P<0.01)、减压枕骨椎管角(127.71°±11.75°vs.118.86°±11.33±,P<0.01)明显大于对照组,差异具有统计学意义。结论成人单纯ACM斜坡长度较正常人明显缩短,枕骨大孔区附近枕骨倾斜角度明显增加。

Study on CT parameters at craniocervical junction of the adult simple Arnold-Chiari malformation I

Objective To investigate the change and significance of computed tomography(CT)parameters at craniocervical junction of simple Arnold-Chiari malformation(ACM)without basilar invagination.Methods The linear and angular parameters were analyzed based on the mid-sagittal reconstruction of CT from 40 cases of adult simple ACM and 20 cases of normal adult control.Results Clivus length(40.66±3.11 mm vs.43.44±3.34 mm,P<0.01),distance from tip of odontoid process to Chamberlain line(1.23±2.41 mm vs.1.25±2.29 mm,P<0.001),distance from tip of odontoid process to McRae line(4.04±1.39 mm vs.4.95±1.29 mm,P<0.05),clivus-canal angle(147.93°±7.84°vs.157.33°±8.51°,P<0.001)were shorter and decompression occipital angle(139.11o±10.14o vs.144.49o±8.03o,P<0.05)were smaller in simple ACM group than in the control group,while Boogard angle(139.11°±10.14° vs.144.49°±8.03°,P<0.05)and decompression occipital canal angle(127.71°±11.75° vs.118.86°±11.33°,P<0.01)of were significantly larger in simple ACM group than in the control.Conclusion The clivus length is shorter the angle of inclination of occipital bone located near the foramen magnum is larger in ACM patients than in the normal adults.