Use of Doppler ultrasonography to detect an elusive communication of a spinal extradural arachnoid cyst
Use of Doppler ultrasonography to detect an elusive communication of a spinal extradural arachnoid cyst
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DOI：
10.1016/j.jocn.2010.10.013
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发表时间：
2011-06-01
影响因子：
2
通讯作者：
Nakamura, Kozo
中科院分区：
文献类型：
--
作者：
Kanetaka, Masakazu;Sugita, Shurei;Nakamura, Kozo
脊髓硬膜外蛛网膜囊肿被认为是硬膜外蛛网膜囊，通过小的硬膜缺损与椎管内蛛网膜下腔相通。目前治疗的主要方法是切除囊肿壁，然后闭塞交通蒂。尽管它在临床上很重要，但囊肿的交通蒂常常是难以捉摸的。作者报告一位57岁的女性，患有硬脑膜外蛛网膜囊肿，伴有顽固性背痛和进行性运动无力。术前影像学检查（包括相位对比MRI）未能识别交通椎弓根。术中多普勒超声清楚地显示了脑脊髓液的脉动流入囊肿。在椎弓根附近还观察到瓣状结构;该结构似乎起到单向阀的作用。多普勒超声检查可能是一个有用的辅助手段，以确定在脊髓硬膜外蛛网膜囊肿难以捉摸的交通的位置。(c)2010爱思唯尔有限公司版权所有。
Spinal extradural arachnoid cysts are thought to be extradural arachnoid pouches that communicate with the intraspinal subarachnoid space through a small dural defect. The mainstay of current treatment is resection of the cyst wall followed by obliteration of the communicating pedicle. Despite it:; clinical importance, the communicating pedicle of the cyst is often elusive. The authors report a 57-year-old woman with an extradural arachnoid cyst with intractable back pain and progressive motor weakness. Preoperative imaging studies, including phase-contrast MRI, failed to identify the communicating pedicle. Intraoperative Doppler ultrasonography clearly demonstrated the pulsatile influx of cerebrospinal fluid into the cyst. A flap-like structure was also noted near the pedicle; this structure appeared to act as a one-way valve. Doppler ultrasonography may be a helpful adjunct for identifying the location of elusive communication in a spinal extradural arachnoid cyst. (c) 2010 Elsevier Ltd. All rights reserved.