Chiari畸形II型MRI病例图片影像诊断分析.doc

《Chiari畸形II型MRI病例图片影像诊断分析.doc》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、Chiari畸形II型(ChiariIIMalformation)MRI病例图片影像诊断分析【临床病史】：患者，2天的婴儿，胎儿期超声检查发现异常。2-day-oldinfantnotedtohaveanabnormalityonprenatalultrasound.zHd影像园XCTMR.com【影像图片】MRI图像zHd影像园XCTMR.comzHd影像园XCTMR.comzHd影像园XCTMR.comzHd影像园XCTMR.com【影像表现】：T1-weightedsagittalimages(Figure1an

2、dFigure2)andT2-weightedaxialimages(Figure3,Figure4,andFigure5)ofthebraindemonstrateasmallposteriorfossawithherniationofthecerebellartonsilsthroughtheforamenmagnum(bluearrows)andabeakedappearanceofthetectum(greenarrow).Thereisassociatedhydrocephalus(redarrow).zHd

3、影像园XCTMR.comzHd影像园XCTMR.comzHd影像园XCTMR.comzHd影像园XCTMR.comzHd影像园XCTMR.comT2-weightedsagittal(Figure6andFigure7)andaxial(Figure8andFigure9)imagesofthespinedemonstrateamyelomeningoceleatthelevelofthelowerlumbarspine(purplearrows).zHd影像园XCTMR.comzHd影像园XCTMR.comzHd影像

4、园XCTMR.com 【影像诊断】：ChiariIIMalformationChiari畸形II型zHd影像园XCTMR.com【诊断要点】：ChiariIImalformationsarecomplexcongenitaldeformitiesinvolvingthebrainstemandcerebellumwithahostofassociateddevelopmentalabnormalities ChiariII型畸形是一种复杂的先天畸形，累及脑干和小脑半球，常有许多伴随的发育异常。zHd影像园XCTMR.c

5、om   Thereisdisplacementofthebrainstemandlowercerebellumintothecervicalspinalcanalandamyelomeningoceleisalmostalwayspresent.脑干和小脑下部移位至颈椎管内并且常常会出现脊膜膨出。【讨论】：TheChiariIImalformationisacomplexanomalywithskull,dural,brain,spinalandspinalcordmanifestations.Itisregarde

6、dasadiseaseofprimaryneurulationandisalmostinvariablyassociatedwithamyelomeningocele.Therearemultipleassociatedfindings,toinclude;protrusionofthecerebellartonsilsthroughtheforamenmagnum,extensionofthecerebellarhemispheresandvermisabovetheincisuraofthetentorium,be

7、akedappearanceofthetectum,fenestrationofthefalx,hydrocephalus,aprominentmassaintermedia,colpocephaly,anddysgensisofthecorpuscallosum.zHd影像园XCTMR.com   ChiariII型畸形是一种复杂的先天畸形，主要有颅骨、硬膜、颅脑、脊椎、脊髓异常表现。被认为是一种原始的神经胚形成病变，几乎都伴有脊膜膨出。同时还有多种伴发的异常，包括小脑扁桃体通过枕骨大孔下疝，小脑半球拉长呈塔状、小脑

8、蚓部超过小脑幕切迹，被盖呈鸟嘴样改变，脑积水、中间块突出，空洞脑、胼胝体发育不良。zHd影像园XCTMR.comzHd影像园XCTMR.comTheChiariIImalformationisthemostcommonseriousmalformationoftheposteriorfossa,withafrequencyofap