CLINICOPATHOLOGICAL CORRELATIONS IN SYRINGOMYELIA USING AXIAL MAGNETIC-RESONANCE-IMAGING
CLINICOPATHOLOGICAL CORRELATIONS IN SYRINGOMYELIA USING AXIAL MAGNETIC-RESONANCE-IMAGING
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DOI：
10.1227/00006123-199508000-00003
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发表时间：
1995-08-01
期刊：
影响因子：
4.8
通讯作者：
PEVSNER, PH
中科院分区：
文献类型：
--
作者：
MILHORAT, TH;JOHNSON, RW;PEVSNER, PH
回顾了115例具有完整神经学和神经放射学结果的患者的非肿瘤性脊髓空洞的轴向磁共振（MR）图像。轴向形态的变化揭示了三种不同的空洞模式。这些模式如下：1）对称性增大的中央空洞（28例患者）; 2）中央空洞在一个或多个局灶性区域中向中心旁扩大（36例患者）; 3）偏心空洞，偏离中心，经常不规则，有时与脊髓软化症相关（51例患者）。脊髓空洞的放射学模式与最近报道的组织病理学结果相关性很好，这些结果区分了中央管的简单扩张、中央管的旁中央解剖扩张和脊髓实质的原发性空洞（管外注射器）。与组织学证实的中央管注射器一样，MR定义的中央腔与影响脑脊液动力学的致病因素相关，包括后脑畸形、脑积水和髓外阻塞性病变。偏心腔类似于管外注射器，通常发生在损伤脊髓组织的疾病中（例如，创伤、梗塞、脑膜炎/蛛网膜炎、关节强硬/椎间盘突出、放射性坏死和横肌萎缩）。分析MR成像时的临床表现建立了以下相关性：1）对称性扩大的中央空洞无症状或产生非特异性神经体征。2)中央腔扩大旁中央与节段性体征相关的旁中央组成部分。3)偏心性空洞产生了各种长束和节段性体征的组合，这些体征通常与脊髓空洞的水平、侧面和特定象限相关。我们的结论是，轴向平面MR成像提供了相当多的信息，横截面形态的空洞，这些信息相关的临床和病理特征，这些病变。
AXIAL MAGNETIC RESONANCE (MR) images of non-neoplastic spinal cord cavities were reviewed in 115 patients with otherwise complete neurological and neuroradiological findings. The variations in axial morphology revealed three distinct cavitary patterns. These patterns were as follows: 1) symmetrically enlarged central cavities (28 patients); 2) central cavities that expanded paracentrally in one or more focal areas (36 patients); and 3) eccentric cavities that were off-center, frequently irregular, and sometimes associated with myelomalacia (51 patients). The radiological patterns of spinal cord cavitation correlated well with recently reported histopathological findings that distinguish simple dilations of the central canal, dilations of the central canal that dissect paracentrally, and primary cavitations of the spinal cord parenchyma (extracanalicular syringes). Like histologically confirmed central canal syringes, MR-defined central cavities were associated with pathogenic factors that affect the dynamics of the cerebrospinal fluid, including hindbrain malformations, hydrocephalus, and extramedullary obstructive lesions. Eccentric cavities resembled extracanalicular syringes and occurred typically with disorders that damage spinal cord tissue (e.g., trauma, infarction, meningitis/arachnoiditis, spondylosis/disc herniation, radiation necrosis, and transverse myelitis). Analysis of clinical findings at the time of MR imaging established the following correlations, 1) Symmetrically enlarged central cavities were asymptomatic or produced nonspecific neurological signs. 2) Central cavities that expanded paracentrally were associated with segmental signs referable to the paracentral component. 3) Eccentric cavities produced various combinations of long tract and segmental signs that could usually be related to the level, side, and specific quadrant of spinal cord cavitation. We conclude that axial plane MR imaging provides considerable information about the cross-sectional morphology of syrinx cavities, and this information correlates well with the clinical and pathological features of these lesions.