Tamaki N, Nagashima T
Department of Neurosurgery Kobe University School of Medicine.
Rinsho Shinkeigaku. 1995 Dec;35(12):1398-9.
Abnormality of CSF hydrodynamics is an important factor of the pathogenesis of syringomyelia. Recent development of cine-MRI visualized real time CSF movement in the syrinx or subarachnoid space. In the present study, twenty cases of syringomyelia associated with Chiari I malformation, 10 cases of syringomyelia associated with spina bifida aperta, and 10 cases of syringomyelia associated with spina bifida occulta were studied with MRI and cine-MRI. The result demonstrated that hydrodynamics of these three groups were different to each other. Chiari I malformation showed CSF hydrodynamic abnormality at the foramen magnum and marked flow void in the syrinx. On the other hand, myelomeningocele showed hydrocephalus and less prominent flow void in the syrinx. Spinal lipoma which is the majority of spina bifida occulta showed no abnormality of CSF hydrodynamics. In conclusion, the selection of treatments should be individualized depending on the hydrodynamical abnormality of each patient.
脑脊液动力学异常是脊髓空洞症发病机制的一个重要因素。电影磁共振成像（cine-MRI）的最新进展实现了对脊髓空洞或蛛网膜下腔中脑脊液实时流动的可视化。在本研究中，对20例合并Chiari I畸形的脊髓空洞症患者、10例合并开放性脊柱裂的脊髓空洞症患者以及10例合并隐性脊柱裂的脊髓空洞症患者进行了磁共振成像（MRI）和电影磁共振成像（cine-MRI）检查。结果表明，这三组患者的脑脊液动力学情况各不相同。Chiari I畸形在枕骨大孔处显示脑脊液动力学异常，脊髓空洞内有明显的血流空信号。另一方面，脊髓脊膜膨出表现为脑积水，脊髓空洞内的血流空信号不那么明显。作为隐性脊柱裂主要类型的脊髓脂肪瘤未显示脑脊液动力学异常。总之，应根据每位患者的脑脊液动力学异常情况进行个体化的治疗选择。
