Oya N, Suzuki Y, Tanemura M, Kojima K, Kajiura S, Murakami I, Yamashita N, Suzumori K
Department of Obstetrics and Gynecology, Nagoya City University Medical School, Nagoya, Japan.
Fetal Diagn Ther. 2000 May-Jun;15(3):156-9. doi: 10.1159/000020996.
Spina bifida is one of the most common open neural tube defects. There are two common types of spina bifida cystica, myelomeningocele and meningocele. Special attention to the thickness of the cystic sac (presence of intact skin and subcutaneous tissue) on magnetic resonance imaging is advantageous for determination of whether the child will profit from cesarean section in order to prevent neurological change (infection and drying of nerve tissue) and for management of spina bifida (most meningocele) during the perinatal period. Furthermore, skin detection may help to predict the prognosis of spina bifida after birth. Meningocele, with intact skin over the cyst, has a better clinical course than myelomeningocele. Some myelomeningoceles with neural tube defects in a lower position, also frequently having an intact skin over the cyst, have almost the same clinical course as a meningocele. From this, we hypothesize that a baby with spina bifida who has intact skin over the cyst might have a good prognosis neurologically. In this report, we concentrate attention on the skin over cysts in 3 cases (1 meningocele and 2 myelomeningoceles).
脊柱裂是最常见的开放性神经管缺陷之一。脊柱裂囊肿有两种常见类型，即脊髓脊膜膨出和脊膜膨出。在磁共振成像中特别关注囊肿囊壁的厚度（有无完整的皮肤和皮下组织），对于确定患儿是否能从剖宫产中获益以预防神经病变（神经组织感染和干燥）以及围产期脊柱裂（大多数为脊膜膨出）的处理是有利的。此外，皮肤检测可能有助于预测出生后脊柱裂的预后。囊肿上方皮肤完整的脊膜膨出，其临床病程比脊髓脊膜膨出要好。一些囊肿上方皮肤也经常完整的低位神经管缺陷型脊髓脊膜膨出，其临床病程与脊膜膨出几乎相同。由此，我们推测囊肿上方皮肤完整的脊柱裂患儿可能在神经方面有良好的预后。在本报告中，我们重点关注了3例病例（1例脊膜膨出和2例脊髓脊膜膨出）囊肿上方的皮肤情况。
