University of Wisconsin, Madison, Wisconsin 53792, USA.
AJNR Am J Neuroradiol. 2012 Aug;33(7):1326-30. doi: 10.3174/ajnr.A2948. Epub 2012 Mar 8.
Upper cervical spinal canal dimension may have a role in abnormal CSF dynamics in patients with Chiari I malformation. We attempted to measure spinal canal tapering from anteroposterior spinal canal dimensions in patients with Chiari I.
Twenty-one patients with Chiari I malformation, including 12 with syringomyelia and 7 patients with IS were identified from a local registry. Age- and sex-matched control subjects with cervical spine MR imaging findings reported as normal were selected from the PACS. The anteroposterior diameter of the spinal canal was measured at C1-C7 on T2-weighted sagittal MR images. The taper ratio of the spinal canal was calculated with the regression line. Goodness of fit was calculated as R(2). Differences between patients with Chiari I and other patients were tested for significance with Kruskal-Wallis tests and multivariate analysis.
Taper ratios averaged -0.6 ± 0.3 mm/level in the patients with Chiari and syrinx, -0.4 ± 0.2 mm/level (mean ± 1 SD) in the patients with Chiari without syrinx, and -0.3 ± 0.5 mm/level in the patients with IS; control groups had average taper ratios of -0.3 ± 0.2 mm/level. Mean R(2) equaled 0.43. Taper ratios in patients with Chiari and syringomyelia differed significantly from those in the control group (P = .003). Taper ratios in the patients with Chiari without syrinx and in patients with IS did not differ significantly from their matched control groups (P = .60 and 0.76, respectively).
Patients with Chiari I and a syrinx have steeper tapering of the upper cervical spinal canal than matched controls.
颅颈交界区椎管形态可能与 Chiari I 畸形患者异常 CSF 动力学有关。我们尝试通过 Chiari I 患者的前后径测量来评估椎管狭窄程度。
从本地数据库中确定了 21 例 Chiari I 畸形患者，包括 12 例伴有脊髓空洞症和 7 例伴有脊髓纵裂。从 PACS 中选择年龄和性别匹配的颈椎 MRI 正常的对照组。在 T2 加权矢状位 MRI 图像上测量 C1-C7 的椎管前后径。用回归线计算椎管的锥度比。拟合优度用 R²表示。用 Kruskal-Wallis 检验和多变量分析来检验 Chiari I 患者与其他患者之间的差异是否有统计学意义。
Chiari 伴脊髓空洞症患者的锥度比平均为-0.6±0.3mm/节段，Chiari 不伴脊髓空洞症患者为-0.4±0.2mm/节段，脊髓纵裂患者为-0.3±0.5mm/节段；对照组的平均锥度比为-0.3±0.2mm/节段。平均 R²为 0.43。Chiari 伴脊髓空洞症患者的锥度比与对照组有显著差异（P=0.003）。Chiari 不伴脊髓空洞症患者和脊髓纵裂患者的锥度比与各自的对照组无显著差异（P=0.60 和 0.76）。
Chiari I 伴脊髓空洞症患者的颅颈交界区椎管上段较对照组更为狭窄。
