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后颅窝的比较形态计量学研究：治疗1型Chiari畸形的有效方法是什么？

The comparative morphometric study of the posterior cranial fossa : what is effective approaches to the treatment of Chiari malformation type 1?

作者信息

Hwang Hyung Sik, Moon Jae Gon, Kim Chang Hyun, Oh Sae-Moon, Song Joon-Ho, Jeong Je Hoon

机构信息

Department of Neurosurgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Korea.

Department of Neurosurgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

出版信息

J Korean Neurosurg Soc. 2013 Nov;54(5):405-10. doi: 10.3340/jkns.2013.54.5.405. Epub 2013 Nov 30.

DOI:10.3340/jkns.2013.54.5.405
PMID:24379947
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3873353/
Abstract

OBJECTIVE

The objective of this study was to investigate changes in the posterior cranial fossa in patients with symptomatic Chiari malformation type I (CMI) compared to a control group.

METHODS

We retrospectively reviewed clinical and radiological data from 12 symptomatic patients with CMI and 24 healthy control subjects. The structures of the brain and skull base were investigated using magnetic resonance imaging.

RESULTS

The length of the clivus had significantly decreased in the CMI group than in the control group (p=0.000). The angle between the clivus and the McRae line (p<0.024), as the angle between the supraocciput and the McRae line (p<0.021), and the angle between the tentorium and a line connecting the internal occipital protuberance to the opisthion (p<0.009) were significantly larger in the CMI group than in the control group. The mean vertical length of the cerebellar hemisphere (p<0.003) and the mean length of the coronal and sagittal superoinferior aspects of the cerebellum (p<0.05) were longer in the CMI group than in the control group, while the mean length of the axial anteroposterior aspect of the cerebellum (p<0.001) was significantly shorter in the CMI group relative to control subjects.

CONCLUSION

We elucidate the transformation of the posterior cranial fossa into the narrow funnel shape. The sufficient cephalocaudal extension of the craniectomy of the posterior cranial fossa has more decompression effect than other type extension of the craniectomy in CMI patients.

摘要

目的

本研究的目的是调查有症状的Ⅰ型Chiari畸形（CMI）患者与对照组相比后颅窝的变化。

方法

我们回顾性分析了12例有症状的CMI患者和24例健康对照者的临床和放射学数据。使用磁共振成像研究脑和颅底的结构。

结果

CMI组斜坡长度比对照组显著缩短（p = 0.000）。CMI组斜坡与McRae线之间的夹角（p < 0.024）、枕骨上部与McRae线之间的夹角（p < 0.021）以及小脑幕与连接枕内隆突至枕骨大孔后缘的线之间的夹角（p < 0.009）均显著大于对照组。CMI组小脑半球的平均垂直长度（p < 0.003）以及小脑冠状面和矢状面上下径的平均长度（p < 0.05）均长于对照组，而CMI组小脑轴位前后径的平均长度（p < 0.001）相对于对照组显著缩短。

结论

我们阐明了后颅窝转变为狭窄漏斗状的情况。在CMI患者中，后颅窝颅骨切除术进行足够的头尾向延伸比其他类型的颅骨切除术延伸具有更大的减压效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/4e5a777241cc/jkns-54-405-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/11ada52e6b49/jkns-54-405-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/3b7a249ef91d/jkns-54-405-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/e6062bc2887d/jkns-54-405-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/120b65263e17/jkns-54-405-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/4e5a777241cc/jkns-54-405-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/11ada52e6b49/jkns-54-405-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/3b7a249ef91d/jkns-54-405-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/e6062bc2887d/jkns-54-405-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/120b65263e17/jkns-54-405-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf1/3873353/4e5a777241cc/jkns-54-405-g005.jpg

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