Byrd S E, Radkowski M A
Department of Radiology, Children's Memorial Hospital, Northwestern University Medical School, Chicago, IL 60614.
J Natl Med Assoc. 1991 Jul;83(7):608-14.
Seven hundred fifty-five children with myelomeningoceles were evaluated radiologically at the Children's Memorial Hospital in Chicago. From our material, we propose a diagnostic radiologic model to accurately evaluate the neurological problems in the myelomeningocele child. This model is based on the clinical symptoms in these children and the radiologic modalities of magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, myelography, and plain radiographs. We found MRI to be the best modality to evaluate the posterior fossa and total spine. Computed tomography and ultrasound are used to evaluate ventricular size. At times MRI may not adequately diagnose subtle cases of tethering of the spinal cord, cord infarction, arachnoid cysts, or diastematomyelia. In these cases, further evaluation may be necessary with real time ultrasound to look at cord pulsations and water soluble myelography with follow through CT to differentiate cord infarction, arachnoid cyst, localized hydromyelia, or diastematomyelia. If MRI is not adequate to completely visualize the cord because of the severe nature of the scoliosis, then water soluble myelography with CT is indicated.
在芝加哥儿童纪念医院对755例脊髓脊膜膨出患儿进行了放射学评估。基于我们的资料，我们提出一种放射学诊断模型，以准确评估脊髓脊膜膨出患儿的神经问题。该模型基于这些患儿的临床症状以及磁共振成像（MRI）、计算机断层扫描（CT）、超声、脊髓造影和普通X线片等放射学检查方法。我们发现MRI是评估后颅窝和整个脊柱的最佳检查方法。CT和超声用于评估脑室大小。有时，MRI可能无法充分诊断脊髓栓系、脊髓梗死、蛛网膜囊肿或脊髓纵裂等细微病例。在这些情况下，可能需要进一步用实时超声观察脊髓搏动，并进行水溶性脊髓造影及后续CT检查，以鉴别脊髓梗死、蛛网膜囊肿、局限性脊髓空洞症或脊髓纵裂。如果由于脊柱侧弯严重，MRI不足以完整显示脊髓，则需进行水溶性脊髓造影及CT检查。
