Barkovich A J, Raghavan N, Chuang S, Peck W W
Department of Radiology, University of California School of Medicine, San Francisco 94143.
AJNR Am J Neuroradiol. 1989 Nov-Dec;10(6):1223-31.
Imaging studies from 13 patients with caudal regression were reviewed retrospectively to assess the spectrum and findings of this anomaly. Seven patients were evaluated with MR and six with myelography (supplemented with CT in three). The level of regression varied from T9 to the coccyx. Although osseous abnormalities were more readily identified and characterized by CT, MR effectively depicted the level of vertebral regression, presence of central spinal stenosis, and vertebral dysraphic anomalies. MR demonstrated a characteristic wedge-shaped (longer dorsally) cord terminus in seven of the patients. When this characteristic cord terminus is seen, imaging of the lower lumbar and sacral regions should be performed to verify the diagnosis of caudal regression. Tethered spinal cords have been described in patients with caudal regression and were seen in two of our patients. We present the first cases of individuals who have survived with absence of vertebrae above the T10 level and an unusual case of caudal regression with absent lumbar vertebrae and preserved lower sacral and coccygeal vertebrae. The syndrome of caudal regression encompasses a wide spectrum of pathology that is analyzed well by modern imaging techniques.
对13例尾椎退化患者的影像学研究进行回顾性分析，以评估这种异常的范围和表现。7例患者接受了磁共振成像（MR）检查，6例接受了脊髓造影检查（其中3例辅以CT）。退化水平从T9到尾骨不等。虽然CT更容易识别和描述骨骼异常，但MR能有效地显示椎体退化水平、中央椎管狭窄的存在以及椎体发育不全异常。MR在7例患者中显示出特征性的楔形（背侧较长）脊髓末端。当看到这种特征性的脊髓末端时，应进行下腰椎和骶骨区域的成像以证实尾椎退化的诊断。尾椎退化患者中曾有脊髓拴系的描述，我们的2例患者也观察到了这种情况。我们报告了首例T10水平以上无椎体而存活的个体病例，以及1例不寻常的尾椎退化病例，该病例腰椎缺如，骶骨下部和尾骨保留。尾椎退化综合征涵盖了广泛的病理学表现，现代成像技术能很好地对其进行分析。
