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以前提出的小脑扁桃体Chiari Ⅰ型畸形合并脊髓空洞症的机制是有争议的,使许多临床观察难以解释,造成现在用作初期治疗的不同术式的流行。在这种背景下,为子探索脊髓空洞症的发病机制,作者在7例病人运用了解剖和动态(分期对照和电影)MR成像,及术中超声摄影,以了解小脑扁桃体和空洞周围的脊髓壁运动的解剖学和动力学,脑脊液和空洞液的运动—静息状态下在呼吸和心搏周期以及在增加肺内压力时(Valsalva)。 所有病例的枕大孔水平蛛网膜下腔均被小脑扁桃体闭塞,脊髓空洞从颈段延伸到下胸段。在解剖和动态MR成像发现脊髓脑脊液和空洞液在心缩期骤然向下运动,舒张期向上运动,在心搏周期脑脊液流过枕大孔的运动受限。术中超声检查证实,心缩期小
The previously proposed mechanism of cerebellar tonsil Chiari type I malformation associated with syringomyelia is controversial and renders many clinical observations difficult to interpret, resulting in the prevalence of different procedures now used as initial treatments. Against this background, in order to explore the pathogenesis of syringomyelia, the authors used anatomic and dynamic (staging and contrast) MR imaging in 7 patients and intraoperative ultrasound to understand the cerebellar tonsils and the spinal cord around the hollow Anatomy and Kinetics of Wall Motion, Movement of Cerebrospinal Fluid and Cavity Fluid - Respiratory and Heart Cycle at Rest and During Increased Pulmonary Pressure (Valsalva). All cases of macular hole horizontal subarachnoid were tonsillar occlusion of the cerebellum, syringomyelia extending from the cervical segment to the lower thoracic segment. In anatomical and dynamic MR imaging, spinal cord CSF and cavitation fluid were found to move abruptly downwards during systole and upward during diastole. Movement of cerebrospinal fluid through the occipital foramen during the cardiac cycle was limited. Intraoperative ultrasound confirmed that the systole is small