Isu T, Iwasaki Y, Nunomura M, Akino M, Koyanagi I, Abe H, Saito H
Department of Neurosurgery, University of Hokkaido School of Medicine.
No Shinkei Geka. 1991 Jan;19(1):41-6.
Posttraumatic syringomyelia is an uncommon but significant late complication of spinal cord injury. It occurs in approximately 1.1 - 3.2% of cases of spinal injuries. With the increasing availability of CT and magnetic resonance imaging (MRI), the incidence of posttraumatic syringomyelia is increasing. The purpose of this report is to show MRI of posttraumatic syringomyelia and to assess the results of surgical treatment. Materials and Methods This series included 16 cases of posttraumatic syringomyelia studied with MRI. 9 out of 16 cases showed delayed deterioration of neurological symptoms following spinal injuries. The interval between the trauma and the delayed symptoms of deterioration was from 2 years 2 months to 32 years (mean, 8 years and 5 months). There were 13 men and 3 women. The age ranged from 22 to 69 years, with a mean age of 42 years. The initial spinal cord injury was located in the lower cervical region in 4 cases, the thoracic region in 8, and the upper lumbar region in 4. All the patients were studied with resistive 0.15T system (Toshiba MRT 15 A) or a superconductive 0.5T system (Toshiba MRT 50 A) or a superconductive 1.5T system (GE Sigma or Siemens Magnetom). Six patients underwent 8 operative procedures for posttraumatic syringomyelia. Syringoperitoneal shunt was performed in 4 patients, syringosubarachnoid shunt in 3 and ventriculoperitoneal shunt in one. Results 1. MRI In all cases, the posttraumatic syringomyelia was easily diagnosed by MRI. The syrinx extended superiorly and/or inferiorly from the area of the old trauma. In 4 out of 16 cases, the syrinx extended into the medulla oblongata.(ABSTRACT TRUNCATED AT 250 WORDS)
创伤后脊髓空洞症是脊髓损伤一种罕见但严重的晚期并发症。它在约1.1% - 3.2%的脊髓损伤病例中出现。随着CT和磁共振成像(MRI)应用的日益广泛,创伤后脊髓空洞症的发病率在上升。本报告的目的是展示创伤后脊髓空洞症的MRI表现并评估手术治疗结果。材料与方法 本系列包括16例经MRI研究的创伤后脊髓空洞症病例。16例中有9例在脊髓损伤后出现神经症状延迟恶化。创伤与症状延迟恶化之间的间隔为2年2个月至32年(平均8年5个月)。有13名男性和3名女性。年龄范围为22至69岁,平均年龄42岁。最初的脊髓损伤位于下颈段4例,胸段8例,上腰段4例。所有患者均使用电阻式0.15T系统(东芝MRT 15 A)或超导0.5T系统(东芝MRT 50 A)或超导1.5T系统(GE Sigma或西门子Magnetom)进行检查。6例患者因创伤后脊髓空洞症接受了8次手术。4例行脊髓 - 腹腔分流术,3例行脊髓 - 蛛网膜下腔分流术,1例行脑室 - 腹腔分流术。结果 1. MRI 在所有病例中,创伤后脊髓空洞症通过MRI很容易诊断。空洞从旧创伤区域向上和/或向下延伸。16例中有4例空洞延伸至延髓。(摘要截短于250字)