Filum terminale lipomas: imaging prevalence, natural history, and conus position
Filum terminale lipomas: imaging prevalence, natural history, and conus position
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DOI：
10.3171/2014.2.peds13528
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发表时间：
2014-05-01
影响因子：
1.9
通讯作者：
Maher, Cormac O.
中科院分区：
文献类型：
--
作者：
Cools, Michael J.;Al-Holou, Wajd N.;Maher, Cormac O.
object.终丝脂肪瘤（FTL）被确定与越来越多的频率，由于越来越多的使用MRI。虽然FTL可能与脊髓栓系综合征（TCS）有关，但在许多情况下，FTL是在没有任何TCS症状的患者中偶然诊断的。FTL的自然发展史尚未明确。作者检索了一家机构14年内的临床和影像学记录，以识别FTL患者。对于FTL患者，审查了临床记录的影像学适应症、表现症状、手术需求和临床结局。对所有临床随访超过6个月的患者进行自然史分析。共确定了436例FTL患者。男217例，女219例。在这些患者中，282例（65%）为成人，154例（35%）为儿童。22例患者（5%）出现TCS症状。52例患者接受了FTL手术（12%）。64例患者（15%）有低位圆锥，21例（5%）有空洞。自然病史分析包括249例患者，平均随访时间为3.5年。在随访期间，只有1例患者发生新的膀胱炎。终丝脂肪瘤是脊柱MRI常见的意外发现，大多数患者没有相关症状。对于无症状患者，未经治疗的自然史通常是良性的。
Object. Filum terminale lipomas (FTLs) are being identified with increasing frequency due to the increasing utilization of MRI. Although an FTL may be associated with tethered cord syndrome (TCS), in many cases FTLs are diagnosed incidentally in patients without any symptoms of TCS. The natural history of FTLs is not well defined.Methods. The authors searched the clinical and imaging records at a single institution over a 14-year interval to identify patients with FTLs. For patients with an FTL, the clinical records were reviewed for indication for imaging, presenting symptoms, perceived need for surgery, and clinical outcome. A natural history analysis was performed using all patients with more than 6 months of clinical follow-up.Results. A total of 436 patients with FTL were identified. There were 217 males and 219 females. Of these patients, 282 (65%) were adults and 154 (35%) were children. Symptoms of TCS were present in 22 patients (5%). Fifty-two patients underwent surgery for FTL (12%). Sixty-four patients (15%) had a low-lying conus and 21(5%) had a syrinx. The natural history analysis included 249 patients with a mean follow-up time of 3.5 years. In the follow-up period, only 1 patient developed new symptoms.Conclusions. Filum terminale lipomas are a common incidental finding on spinal MRI, and most patients present without associated symptoms. The untreated natural history is generally benign for asymptomatic patients.