Barkovich A J, Sherman J L, Citrin C M, Wippold F J
AJNR Am J Neuroradiol. 1987 Mar-Apr;8(2):319-27.
Twenty-seven MR scans of 20 patients surgically treated for syringomyelia were reviewed. Thirteen patients had syringomyelia associated with the Chiari I malformation, four cases were posttraumatic, and three were idiopathic. The operations performed included syringosubarachnoid and syringoperitoneal shunts, myelotomies, and foramen magnum decompressions. Three of the foramen magnum decompressions had associated posterior fossa duroplasties, two had fourth-ventricle-to-subarachnoid shunts, and two had plugging at the obex. On 20 scans of patients in whom the syrinx cavity had been shunted, the shunt catheter was seen in 15 (75%). When adequately treated by shunting, syringes are completely collapsed and show no flow void. Nine patients were treated by foramen magnum decompression; all were well seen by MR. Three of these patients had a poor clinical result; these were the only patients in whom CSF was not seen between the foramen magnum and the neural structures of the posterior fossa on any images. The proposed mechanisms of syrinx formation and extension are discussed and related to the surgical procedures used to treat syringomyelia.
回顾了20例因脊髓空洞症接受手术治疗患者的27次磁共振扫描结果。13例患者的脊髓空洞症与Chiari I畸形相关，4例为创伤后所致，3例为特发性。所施行的手术包括脊髓空洞 - 蛛网膜下腔分流术、脊髓空洞 - 腹膜分流术、脊髓切开术和枕骨大孔减压术。3例枕骨大孔减压术同时进行了后颅窝硬脑膜成形术，2例进行了第四脑室 - 蛛网膜下腔分流术，2例在闩部进行了填塞。在20例脊髓空洞腔已行分流术患者的扫描中，15例（75%）可见分流导管。经分流术充分治疗后，脊髓空洞完全塌陷且无血流信号。9例患者接受了枕骨大孔减压术；磁共振成像均清晰显示。其中3例临床效果不佳；这是仅有的在任何图像上枕骨大孔与后颅窝神经结构之间均未见脑脊液的患者。文中讨论了脊髓空洞形成和扩展的推测机制，并与用于治疗脊髓空洞症的手术方法相关联。
