人工体神经-内脏神经反射弧建立术前MRI检查的价值

目的 评价MRI在人工体神经-内脏神经反射弧建立术前的诊断价值。资料与方法 对73例神经源性膀胱．拟行人工体神经-内脏神经反射弧建立术的患者进行术前MRI检查。结果 脊髓栓系综合征57例．骨折并脊髓损伤10例,椎管内占位3例．马尾神经粘连3例。结论 神经源性膀胱患者人工体神经-内脏神经反射弧建立术前应进行MRI检查。MRI对于发现脊髓栓系综合征、骨折并脊髓损伤、椎管内占位性病变以及马尾神经粘连有重要意义。     

脊髓栓系综合征MRI与手术对比研究

目的:探讨MRI在诊断脊髓栓系综合征中的价值。方法:回顾性分析21例手术病理证实的脊髓栓系综合征的磁共振资料,并与手术及病理结果相对照。结果:本组直接征象:脊髓圆锥低位(21/21),终丝粗大紧张(21/21),脊髓及马尾粘连(21/21);间接征象:腰骶管发育不良(11/21)、脊髓缺血性改变(4/21),脊髓空洞(7/21),背部皮毛窦(9/21),脊髓脊膜膨出(15/21),椎管内脂肪瘤(14/21),椎管内囊肿(7/21),神经源性膀胱(11/21),脊柱侧弯畸形(9/21),椎体畸形(2/21),脊柱裂(7/21)及脊髓纵裂(2/21)。结论:MRI是脊髓栓系综合征最有效的检查方法,能为脊髓栓系综合征的诊断和手术提供有价值的资料,具有重要的临床意义。     

人工体神经-内脏神经反射弧建立术前腰骶部脊神经的MRI研究

目的 探讨MRI在人工体神经-内脏神经反射弧建立术前腰骶部脊神经评估的价值。方法 对10例神经源性膀胱患者均采用常规MRI、稳态构成干扰序列（constructive inference in steadystate，CISS）成像，并对T2W CISS三维（3D）原始数据进行多平面重组（multiple planar reformation，MPR）。结果 MRI发现，脊髓栓系综合征5例，其中1例合并脊髓血管畸形，脊神经返折走行，出硬脊膜处脊神经数目异常；脊髓损伤4例，椎管内占位病变1例，脊神经漂浮下行，神经根数目正常。结论 常规MRI及T2W CISS 3D检查对人工体神经-内脏神经反射弧建立术前脊神经的评估具有重要价值。MPR可以清晰的显示脊神经的走行及前后根的排列。     

脊髓栓系综合征的MRI表现

目的：评价MRI对脊髓栓系综合征的诊断价值。材料和方法：回顾性分析46例脊髓栓系综合征患者的MRI表现。结果：脊膜膨出及脊髓脊膜膨出／脂髓膨出20例（43.5％）。椎管内脂肪瘤／脂肪沉积18例（391％）。脊髓终丝增粗17例（37％），脊髓纵裂12例（21．6％）。脊髓圆锥空洞／软化灶8例（17％）。皮样囊肿2例（4．4％）。结论：MRI可明确显示引起脊髓栓系的原因，矢状位扫描可显示病变全貌，横轴位可准确显示脊髓空洞、圆锥或终丝粘连部位，对椎管闭合不全也能较好地显示，可以为手术治疗提供可靠依据。     

脊髓栓系综合征的MRI诊断

目的 了解脊髓栓系综合征(TCS)的MRI表现及其诊断价值，提高对该疾病的诊断水平。方法 搜集经手术证实的21例脊髓栓系综合征的临床及MRI资料，分析临床表现及MRI所见。结果 21例中脊髓圆锥均低于L2椎体平面以下。其中，4例表现为单纯脊髓圆锥低位；5例伴有脂肪脊髓脊膜膨出；2例伴有脊膜膨出；3例伴有先天性背部皮毛窦；7例合并有椎管内肿瘤，其中脂肪瘤2例，畸胎瘤2例，表皮样囊肿2例，皮样囊肿1例。结论 MRI是脊髓栓系综合征最有效的检查方法，能明确显示脊髓圆锥的位置、形态及伴发畸形，对诊断TCS具有重要价值。     

脊髓栓系综合征MRI诊断的临床价值

目的：探讨脊髓栓系综合征（TCS）的MRI特点及其诊断价值。方法：回顾性分析21例经手术病理证实的TCS的MRI表现，并与手术所见、临床表现进行对照分析。结果：21例TCS均表现为脊髓低位。椎管内脂肪瘤8例，脊髓纵裂2例，双干脊髓1例，畸胎瘤3例，囊肿1例，脂肪脊膜膨出6例。21例均合并神经管闭合不全，其中6例无任何临床症状为查体时发现。MRI与临床、手术所见相符。结论：MRI对TCS患者的确诊具有重要的价值，能明确显示脊髓圆锥的位置、栓系的部位，伴发的畸形，为手术提供可靠的依据。     

3.0T MR骶神经成像在神经源性膀胱病因探究中的价值

目的:探讨3.0T MR腰骶丛神经成像在探究神经源性膀胱(NB)病因中的价值.方法:回顾性分析119例NB患者的临床和影像资料.结果:影像诊断包括神经根肿瘤69例,骶神经多发异常T2 WI高信号28例,脊髓栓系18例,隐性脊柱裂14例,骶尾部软组织包块3例,神经节细胞瘤2例,神经纤维瘤病1例,骶椎转移瘤1例,骶神经无异常27例.骶神经占位最常发生于S2神经根(62根),其次为S1(41根)、S3(28根)、S4-S5(24根);病变直径≥15 mm者34枚,10～14 mm者36枚,5～10 mm者37枚,≤5 mm者61枚.神经根占位MRI表现为椭圆形T2 WI高信号,T1 WI等信号;脊髓栓系MRI可见骶管内脂肪瘤、圆锥低位和马尾牵拉.骶尾部成熟畸胎瘤表现为T1WI、T2 WI混杂高、低信号;神经节细胞瘤多呈T1 WI低信号、T2 WI高信号.神经纤维瘤病表现为位于脊柱旁的T1WI等信号、T2 WI稍高信号;隐形脊柱裂表现为椎管畸形、棘突及椎板缺损.结论:MRI能准确、直观显示骶丛神经的特征及病灶的数量、位置,有助于NB的诊断、鉴别诊断及规范化治疗.     

神经源性膀胱的MRI诊断

目的:分析神经源性膀胱的MRI表现,评价MRI在神经源性膀胱诊断中的价值。方法:对18例经MRI检查神经源性膀胱进行回顾性分析,结合文献进行讨论。结果:18例均见膀胱扩张增大,并见大量尿液潴留,其中12例中膀胱呈典型基底部增宽,呈向前后侧突出,顶端变窄,呈"塔状"改变,尤以T2WI矢状位显示最为清晰;16例膀胱壁呈不规则增厚,黏膜面凹凸不整;15例伴膀胱壁结节样或乳头状隆起;12例伴发膀胱憩室,于脂肪抑制序列观察最为明显。结论:神经源性膀胱的MRI表现有特征性,具有实用价值。     

小儿脊髓神经管缺陷的MRI诊断价值(附55例报告)

目的:回顾55例小儿脊髓神经管缺陷的MRI表现并复习文献,探讨该病的MRI诊断价值。方法:男33例,女22例,使用1.5T超导MR机行病变区脊柱扫描。结果:脊髓脊膜膨出12例;脊膜膨出1例;脂肪脊髓脊膜膨出9例;终丝脂肪瘤4例;硬膜内脂肪瘤3例;背侧上皮窦12例;原发性脊髓栓系综合征4例;脊髓纵裂4例;神经肠源性囊肿2例;术后复查4例。结论:MRI是诊断该病最有效的无创检查方法,可以清晰显示脊髓栓系、脊髓神经组织粘连及压迫以及脊髓空洞积水,评估脂肪瘤的范围,进行脊髓纵裂分型。     

MRI对脊髓栓系综合征的诊断及其临床意义

目的评价MRI对脊髓栓系综合征（tethered cord syndrome，TCS）的诊断价值及其临床意义。方法回顾性分析21例TCS患者的MRI表现，依据其特点分类阐述，并结合临床评价MRI对该病的诊断价值。结果21例TCS中单纯型脊髓栓系者6例，复杂型脊髓栓系15例，其中，合并终丝脂肪瘤者5例；合并脊柱裂脊膜膨出者7例；合并脊髓纵裂畸形者2例；合并骶管囊肿者1例。MRI可以清晰显示各种类型的TCS。结论MRI可以作为TCS诊断的首选影像学方法，能够为临床提供准确的影像学信息。     

神经源性膀胱患者腰骶部的MR研究

目的探讨神经源性膀胱患者腰骶部病变的MR特征。方法对90例临床诊断为神经源性膀胱并疑有腰骶部病变的患者行MR检查,观察腰骶部有无异常并对异常的MR表现进行归纳分类。结果90例中,MR发现腰骶部异常61例,阳性率68%,61例阳性病例中,MR诊断正确60例,准确率为98.5%。阳性病例腰骶髓病变主要为椎体脊髓畸形(25例),椎管内肿瘤(19例),下腰椎椎间盘突出(13例)3大类。结论MR对诊断脊髓疾病有很好的价值,是临床以神经源性膀胱为首发症状的病因检出的重要手段之一。     

Investigation of vesicoureteral reflux with colour Doppler sonography in adult patients with spinal cord injury

The aim of the study was to evaluate prospectively the performances of colour Doppler sonography for detection of vesicoureteral reflux in adult patients with neurogenic bladder due to spinal cord injury. One hundred eighty-seven adult patients who had developed neurogenic bladder due to spinal cord injury underwent retrograde cystography and sonographic evaluation by B-mode and colour flow Doppler sonography (CFDS). Results of both examinations were analyzed independently by two radiologists. Representative images of the sonographic evaluations were recorded on videotape and CD-Rom. CFDS detected reflux in 20 ureters while retrograde cystography revealed vesicoureteral reflux (VUR) in 25 ureters of a total of 374 ureters, which were examined by both methods. Sonography detected all cases of grades IV and V of reflux, 7 of 8 (87.5%) of grade III, 5 of 6 (83.3%) of grade II, and 4 of 7 (57.14%) of grade I. There were 6 false-positive and 5 false-negative findings with Doppler examination compared with retrograde cystography. Therefore, sensitivity and specificity of sonographic examination were 80 and 98.28%, respectively, with a positive predictive value of 76.92%. Colour flow Doppler sonography can play an important role in detection of VUR in spinally injured adult patients with neurogenic bladder and can be an effective imaging tool for follow-up.     

Tethered cord syndrome: ventral displacement of the spinal cord at the thoracolumbar junction in magnetic resonance imaging

Purpose: to determine the route of the spinal cord at the thoracolumbar junction in a sagittal MRI taken in the supine position in tethered cord syndrome. Patients and methods: We retrospectively studied the MRIs of 11 cases with tethered cord syndrome and the MRIs of 33 individuals without spina bifida were used as a control. When the anteroposterior diameter of the low intensity area behind the spinal cord on the sagittal T1 weighted images taken in the supine position was more than one third the anteroposterior diameter of the cord at T12/L1, the spinal cord was defined as being displaced ventrally. Results: Ventral displacement was found in 6 cases (VD group), but not in the rest (non-VD group). None of the control group showed ventral displacement. There was a tendency for motor weakness to be more severe in the VD group. Conclusion: In some cases with tethered cord syndrome, the spinal cord takes a ventral route at the thoracolumbar junction even on MRI taken in the supine position. This finding may be useful in predicting the severity of the motor weakness in the lower extremity.     

Fixed spinal cord: diagnosis with MR imaging

Pulsatile motion of the spinal cord was examined with phase imaging techniques. Sagittal images of the spinal cord were obtained at different times of the cardiac cycle in healthy volunteers, as well as in patients in whom the spinal cord either was tethered, was compressed, or contained an intramedullary lesion. Pulsatile velocity changes of the spinal cord, observed on the phase images, were most marked at the cervical-upper thoracic level. Cord motion was found to be significantly decreased in cases in which the cord was either tethered or compressed. Cord enlargement due to an intramedullary lesion generally did not lead to decreased cord motion. Imaging of pulsatile cord motion may be clinically useful in evaluating diseases restricting cord motion or changing the status of parenchymal compliance.     

儿童隐性脊柱裂的MRI诊断

目的：总结儿童隐性脊柱裂的MR影像，提高对该疾病的诊断水平。方法：搜集1995-2002年经手术病理证实的36例儿童隐性脊柱裂脚资料，分析其MRI表现。结果：本组隐性脊柱裂包括原发性脊髓栓系综合征11例，硬膜下脂肪瘤9例，脊柱纵裂8例，皮毛赛6例，肠源性囊肿2例。结论：MRI是目前诊断儿童脊柱裂最有效的方法，但有其局限性，对于复杂的椎管畸形还须结合CT考虑。     

脊柱闭合不全的MR影像诊断（二）隐性脊柱闭合不全

本组隐性脊柱闭合不全包括脊髓纵裂２例、侧位脊膜膨出１例、脂肪瘤６例、终丝脂肪瘤４例、胆脂瘤５例、脊髓低位９例、肠源性囊肿１４例和骶骨发育不良２例。ＭＲ对隐性脊柱闭合不全的诊断具有较高的价值。矢状面图像可清楚地显示病变的全貌。在诊断脊髓低位和肠源性囊肿时，横断面检查十分重要。     

Lipomyeloschisis associated with thoracic syringomyelia and Chiari I malformation

Co-existence of Chiari I malformation and myelomeningocele is uncommon. Syringomyelia, when associated with a Chiari I malformation, classically involves the cervical spinal cord. Intramedullary extension of lipoma is unusual in lipomyeloschisis. A patient with lumbar lipomyelomeningocele with tethered cord, lower thoracic syringomyelia and Chiari I malformation, shown by MRI is reported.