Koyama S, Sekido K, Yamaguchi K
Department of Neurosurgery, Kanagawa Children's Medical Center, Yokohama, Japan.
No Shinkei Geka. 1989 Apr;17(4):393-8.
We experienced two cases of diastematomyelia. Magnetic Resonance Imaging (MRI) was very useful in definitive diagnosis and detection of associated abnormalities. Case 1 was a 5-year-old boy. He was admitted because of foot-length discrepancy. He also presented scoliosis, hypertrichosis and pigmentation in his back skin, and foot deformity. Myelography and CT myelography revealed bony septum and split cord at midthoracic level, and two separated taut filum terminalis in the lumbosacral region. Sagittal MR image delineated the taut filum terminale adhering to the lipomatous tissue at the end of dural sac. Removal of the septum and division of the taut filum terminalis were performed. Case 2 was a newborn baby. She was admitted because of bulging of the back skin in the lumbosacral region and foot deformity. Plain CT revealed bony septum at lumbar level. Myelography was not performed. MR image demonstrated the split cord in its entirety, the bony septum and its structures in detail, and the associated lipoma. Removal of the septum and resection of the lipoma were performed. Diastematomyelia has been able to be definitely diagnosed only by myelography or CT myelography. In our case, MR image gave visualization of septum and split cord in its entirety, and also detected the associated anomalies such as lipoma, tight filum terminale. MRI has possibility of becoming a diagnostic technique in place of myelography and CT myelography.
我们遇到了两例脊髓纵裂的病例。磁共振成像(MRI)在明确诊断和发现相关异常方面非常有用。病例1是一名5岁男孩。他因双下肢长度不等入院。他还存在脊柱侧弯、背部皮肤多毛和色素沉着以及足部畸形。脊髓造影和CT脊髓造影显示胸段中部有骨隔和脊髓分裂,腰骶部有两条分离且紧绷的终丝。矢状位MR图像显示紧绷的终丝附着于硬脊膜囊末端的脂肪组织。进行了骨隔切除和紧绷终丝切断术。病例2是一名新生儿。她因腰骶部背部皮肤隆起和足部畸形入院。普通CT显示腰椎水平有骨隔。未进行脊髓造影。MR图像完整地显示了脊髓分裂、骨隔及其结构以及相关脂肪瘤。进行了骨隔切除和脂肪瘤切除术。脊髓纵裂过去只能通过脊髓造影或CT脊髓造影才能明确诊断。在我们的病例中,MR图像完整地显示了骨隔和脊髓分裂,还检测到了如脂肪瘤、紧绷终丝等相关异常。MRI有可能成为取代脊髓造影和CT脊髓造影的诊断技术。