目的:研究Chiari畸形I型(CMI)患者颅颈部蛛网膜下腔(SS)形态学改变及其在疾病发生和外科治疗中的意义。方法:通过磁共振成象(MRI)技术观测颅颈部蛛网膜下腔形态学指标,结合临床,对病例组与正常对照组、术前与术后,进行对比分析;手术采用后颅窝减压、枕大池成形术。结果:CMI患者颅颈部既有先天性发育异常,又有后天继发性改变,导致其整个颅颈部SS较对照组显著变窄(前池、侧池、枕大池均明显变窄);术后均有不同程度增宽,术后SS狭窄较术前改善明显者,其临床症状恢复和空洞消退也快而明显。结论:颅颈部SS狭窄导致脑脊液循环障碍在CMI疾病发生发展和转归中起重要作用,外科治疗应以解除颅颈部蛛网膜下腔梗阻为目的,减压一定要充分,重建颅颈部蛛网膜下腔。 Objective: To study the morphological changes of craniocervical and subarachnoid (SS) in Chiari malformation type I (CMI) patients and its significance in the pathogenesis and surgical treatment of the disease. Methods: The morphology of subarachnoid space in craniocervical and cranial neck was observed by magnetic resonance imaging (MRI) technique. The clinical data were compared between the cases and the normal control group, preoperatively and postoperatively. The posterior fossa lesion Pressure, occipital cisternoplasty. Results: Both craniocervical and craniocervical diseases of CMI patients had both congenital dysplasia and secondary changes of acquired disease, leading to a significant narrowing of the entire craniocervical SS compared with the control group (the forebrain, lateral pool and occipital cistern were significantly narrowed). All patients had widened to varying degrees after operation, and postoperative SS stenosis improved significantly compared with that before operation. The recovery of clinical symptoms and emptying were also quick and obvious. CONCLUSIONS: Cerebral spinal cord stenosis caused by cerebellar SS stenosis plays an important role in the development and prognosis of CMI. Surgical treatment should aim to relieve the subarachnoid obstruction in the cranial neck and neck. Decompression must be sufficient to reconstruct the cranial neck Subarachnoid space.