Enzmann D R, O'Donohue J, Rubin J B, Shuer L, Cogen P, Silverberg G
AJR Am J Roentgenol. 1987 Jul;149(1):149-57. doi: 10.2214/ajr.149.1.149.
Because of its sensitivity to fluid motion, MR imaging was used to investigate fluid dynamics in syringomyelia. Three major findings characterized syringomyelia: pulsatile fluid in cysts, nonpulsatile fluid in cysts, and damaged cord tissue. The fluid in preoperative syrinx cavities pulsated in a fashion similar to subarachnoid CSF. Pulsation was more prominent in large cysts but was also seen in small cysts. Nonpulsatile cysts were generally of smaller diameter, were shorter in length, and often were single; they could, however, coexist with pulsatile cysts. Nonpulsatile cysts had etiologies similar to those of pulsatile cysts: Chiari malformation, trauma, and unknown. Damaged cord, characterized by abnormal high signal on T2-weighted sequences, was seen in 15 of 16 patients and could be either focal or diffuse but was always adjacent to syrinx cavities. Postsurgical MR scans had a lower incidence of pulsatile cysts. In five patients with both pre- and postoperative MR scans, shunting of the cyst reduced the size of the pulsating cyst (two patients) or reduced the size of the cyst and eliminated pulsation altogether (three patients). Axial, T2-weighted images are recommended in the investigation of spinal cord cysts to determine the presence or absence of pulsatile fluid. The presence of pulsation indicates a nonneoplastic cyst. The absence or reduction of CSF pulsation may prove to be a valuable indicator of the success of a shunting procedure.
由于对流体运动敏感，磁共振成像（MR成像）被用于研究脊髓空洞症中的流体动力学。脊髓空洞症有三个主要特征：囊肿内的搏动性液体、囊肿内的非搏动性液体以及受损的脊髓组织。术前脊髓空洞腔内的液体搏动方式与蛛网膜下腔脑脊液相似。大囊肿中的搏动更明显，但小囊肿中也可见到。非搏动性囊肿通常直径较小、长度较短，且多为单个；然而，它们可与搏动性囊肿共存。非搏动性囊肿的病因与搏动性囊肿相似：Chiari畸形、创伤及不明原因。在16例患者中有15例可见脊髓受损，表现为T2加权序列上的异常高信号，可为局灶性或弥漫性，但总是与脊髓空洞腔相邻。术后MR扫描中搏动性囊肿的发生率较低。在5例术前行MR扫描且术后也行MR扫描的患者中，囊肿分流使搏动性囊肿体积减小（2例患者）或囊肿体积减小且搏动完全消失（3例患者）。在脊髓囊肿的检查中，推荐使用轴向T2加权图像来确定是否存在搏动性液体。搏动的存在提示为非肿瘤性囊肿。脑脊液搏动的消失或减弱可能是分流手术成功的一个有价值指标。
