Tapering of the Cervical Spinal Canal in Patients with Distended or Nondistended Syringes Secondary to Chiari Type I Malformation
Tapering of the Cervical Spinal Canal in Patients with Distended or Nondistended Syringes Secondary to Chiari Type I Malformation
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DOI：
10.3174/ajnr.a3967
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发表时间：
2014-10
影响因子：
3.5
通讯作者：
Z. Zhu;S. Sha;X. Sun;Z. Liu;H. Yan;W. Zhu;Z. Wang;Y. Qiu
中科院分区：
文献类型：
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作者：
Z. Zhu;S. Sha;X. Sun;Z. Liu;H. Yan;W. Zhu;Z. Wang;Y. Qiu
背景和目的：最近的研究表明颈椎椎管变陡被认为在Chiari畸形相关脊髓空洞症的病理生理学中起作用。本研究旨在确定扩张和非扩张注射器患者的颈椎椎管锥度比率是否存在差异。材料和方法：77例10~18岁青少年随机分为两组：单纯空洞组44例，非膨胀型空洞组33例。在T2加权MR图像上，测量各颈椎节段椎管前后径，用最小二乘回归拟合线性趋势线，计算椎管锥度比。比较两组之间的锥度比率，并根据年龄和性别进一步评估。结果：在非膨胀组中，C_1~C_7、C_1~C_4、C_4~C_7的锥度比分别为−0.73±0.57、−1.61±0.98、−0.04±0.54，均明显大于膨胀组(P分别为.001、.004、.033)。根据颈椎水平绘制的平均直径，两组椎管最窄的区域都出现在C4处。此外，在男性和女性之间，或者在年龄较大(>；14岁)和较年轻(≤，14岁)患者之间，锥度比率没有显著差异。结论：膨胀型与非膨胀型患者颈椎椎管锥度比值不同，提示脊髓空洞与颈椎解剖结构之间存在相互作用。
BACKGROUND AND PURPOSE: Steeper tapering of the cervical spinal canal as documented in recent studies is thought to have a role in the pathophysiology of Chiari malformation-associated syringomyelia. This study aimed to determine whether taper ratio of the cervical spinal canal differs between patients with distended and nondistended syringes. MATERIALS AND METHODS: Seventy-seven adolescents (10–18 years) were divided into 2 groups: 44 with distended syrinx and 33 with nondistended syrinx. On T2-weighted MR images, anteroposterior diameter of the spinal canal was measured at each cervical level, and a linear trend line was fit by least squares regression to calculate the taper ratio. Taper ratios were compared between the 2 groups and further evaluated with respect to age and sex. RESULTS: In the nondistended group ND, the taper ratios for C1–C7, C1–C4, and C4–C7 averaged −0.73 ± 0.57, −1.61 ± 0.98, and −0.04 ± 0.54, respectively, all of which were significantly steeper than those observed in the distended group (P = .001, .004, and .033, respectively). Regarding the average diameters plotted by cervical level, the narrowest region of the canal was found to occur at C4 in both groups. In addition, no significant differences in taper ratio were noted between males and females, or between older (>14 years) and younger patients (≤14 years). CONCLUSIONS: Taper ratios of the cervical spinal canal were found to be different between patients with distended and nondistended syringes, indicating a reciprocal interaction between the syrinx and the cervical spine anatomy.