摘要
目的通过观察终丝牵拉综合征(TFTS)患儿临床表现和MRI显示终丝病变类型的特点,提高对TFTS的认识,为TFTS临床诊断与治疗提供依据。方法回顾性分析37例TFTS患儿临床资料,包括体格检查、全脊柱X线片、全脊柱螺旋CT、全脊髓MRI、尿流动力学、术后病理结果及术后恢复效果。根据MRI终丝影像学表现,将其分为2组:一组为终丝脂肪变,另一组为终丝增粗(直径>2 mm),比较2组患儿之间的差异。结果 37例TFTS患儿的MRI显示终丝脂肪变24例(64.9%),终丝增粗(直径>2 mm)13例(35.1%)。2组患儿在下肢畸形、脊柱发育畸形和术后恢复效果方面无明显差异,但在腰背部皮肤异常和大小便功能障碍方面有较明显差别,腰骶部皮肤异常改变23例(62.3%)。其中终丝增粗组5例(13.5%),终丝脂肪变组18例(48.8%);大小便功能障碍26例(70.2%)。其中终丝增粗组7例(18.9%),终丝脂肪变组19例(51.3%)。37例患儿尿流动力学均提示有异常。术后病理结果提示终丝脂肪及纤维组织增生。结论 TFTS患儿的终丝存在异常改变,MRI显示终丝病变类型多为直径增粗和脂肪变,病变终丝切断对改善症状有效。诊断TFTS需综合临床信息,其中尿流动力学和MRI是诊断的关键指标。
Objective To improve the understanding of tight ilium terminale syndrome （TFTS） and provide basis for diagnosis and treatment of TFTS through observing the clinical manifestations and disease types of ilium terminale by magnetic resonance imaging（MRI） in chil- dren with TFI＇S. Methods The clinical data collected from 37 patients with TFTS were reviewed retrospectively, including physical examinations, spine X -ray, spiral computed tomograph, MRI, urodynamics and pathology results and postoperative outcomes. The children were classified into 2 groups by MRI of ilium terminale （I^F） ; one was thick FT （diameter over 2 ram） and the other was fatty FT. The differences were compared between 2 groups. Results Among 37 patients, MRI showed fatty FT in 24 cases （64.9% } and thick FT in 13 cases （35.1%）. There was no significant difference between 2 groups in lower limb deformities, spinal malformations and postoperative out- comes. But there were significant differences in lower back midline skin abnormalities and bowel and bladder dysfunction. There were 23 ca- ses with the lumbosacral skin abnormal changes （62.3%） , 5 cases （ 13.5% ） in the thick FT group, and 18 cases（48.8% ） in the fatty FT group. There were 23 cases（70.2% ） with bowel and bladder dysfunction,7 cases （ 18.9% ） in the thick FT group, and 19 cases （51.3%） in the fatty FT group. Urodynamics indicated abnormalities in 37 patients. The pathologic result of FT after surgery suggested that there were fat and fibrous tissue hyperplasia. Conclusions There are abnormal changes in ilium terminale in TFTS. The disease types of FT are terminale thickness and fatty filum. Resection of diseased ilium is effective for improving symptoms. Diagnosis of TFTS needs comprehensive information of patient. Urodynamics and MRI are key criteria for diagnosis.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第23期1816-1818,共3页
Journal of Applied Clinical Pediatrics
关键词
终丝牵拉综合征
终丝
磁共振成像
儿童
tight ilium terminale syndrome
filum terminale
magnetic resonance imaging
child
