Whole-spine magnetic resonance imaging in patients with neurofibromatosis type I and spinal deformity
Whole-spine magnetic resonance imaging in patients with neurofibromatosis type I and spinal deformity
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DOI：
10.1097/01.bsd.0000133466.97241.50
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发表时间：
2004-12-01
影响因子：
--
通讯作者：
Saifuddin, A
中科院分区：
文献类型：
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作者：
Ramachandran, M;Tsirikos, TI;Saifuddin, A
目的：全脊柱磁共振成像（MRI）已被推荐用于 1 型神经纤维瘤病（NF-1）患者的术前评估。然而，尚无大型研究确定 MRI 在这种疾病的分类和治疗中的作用。对 27 名表现为脊柱畸形的 NF-1 患者进行回顾性研究，对他们进行平片和全脊柱 MRI 检查，以确定全脊柱 MRI 在 NF-1 和脊柱畸形患者的分类和治疗中的作用。方法：对 27 名神经功能完整的 NF-1 和脊柱畸形患者的医疗记录、X 线照片和 MRI 研究进行了至少 2 年的随访。结果：研究组由 27 名患者组成，根据放射学特征，其中 11 名患者被归类为非营养不良型，16 名患者被归类为营养不良型。所有患者神经功能均正常。在非营养不良组中，MRI 发现四名患者出现营养不良变化（与其中一名患者的曲线进展率较高相关）。在非营养不良组和营养不良组中，椎管内和椎旁神经纤维瘤的发病率很高（总体为 37%）。在营养不良组中，在曲线凸面附近发现了明显更多的肿瘤。结论：在患有 NF-1、神经功能正常和脊柱畸形的儿童和成人患者的混合人群中，整个脊柱的 MRI 被证明有助于识别隐匿性椎体发育不良以及显示椎管内和椎旁肿瘤。
Objective: Whole-spine magnetic resonance imaging (MRI) has been recommended in the preoperative evaluation of patients with neurofibromatosis type 1 (NF-1). However, no large study has identified the role of MRI in the classification and management of this condition. A retrospective study of 27 patients with NF-1, presenting with spinal deformity, who were investigated with plain radiographs and whole-spine MRI, was conducted to determine the role of whole-spine MRI in the classification and management of patients with NF-1 and spinal deformity.Methods: The medical records, radiographs, and MRI studies of 27 neurologically intact patients with NF-1 and spinal deformity, who had been followed for a minimum of 2 years, were reviewed.Results: The study group comprised 27 patients, 11 of whom were categorized as having nondystrophic and 16 as having dystrophic curves based on radiographic features. All patients had normal neurologic function. In the nondystrophic group, MRI identified dystrophic changes in four patients (associated with a high rate of curve progression in one). A high incidence of intraspinal and paraspinal neurofibromas was documented (overall 37%) in both nondystrophic and dystrophic groups. Significantly more tumors were identified adjacent to the convexity of the curve in the dystrophic group.Conclusion: in a mixed population of pediatric and adult patients with NF-1, normal neurologic function, and spinal deformity, MRI of the whole spine proved useful in the identification of occult vertebral dysplasia and in demonstration of intraspinal and paraspinal neoplasms.