【摘要】 目的 探讨相位对比电影-磁共振成像（Cine PC-MRI）技术在小脑扁桃体下疝（Arn old-C hiari）畸形手术疗效评估中的应用。方法 选取2018年8月—2022年9月期间多中心收集的65例行Arnold-Chiari畸形手术治疗的患者作为研究对象。术后均随访6个月。比较患者术前、术后6个月的预后、生活质量、寰齿间距（ADI）值、脊髓空洞直径、后颅窝斜坡长度、枕骨大孔横径、后颅窝高径长度及脑脊液流速,随访期间的并发症情况。结果 术后6个月,患者芝加哥Chiari结果 量表（CCOS）评分及健康相关生活质量评分（HRQoL）高于术前（P<0.05）;随访期间,有3例进行枕大池重建术的患者伤口发生脑脊液漏,给予腰大池引流,7d后伤口愈合良好。术后6个月,患者寰齿间距（ADI）值及脊髓空洞直径低于术前;后颅窝斜坡长度及后颅窝高径长度长于术前;桥脑延髓池层面、中脑导水管层面及颈椎间盘层面的每搏输出量（SV）、平均流量（MF）均高于术前;头向峰值流速(V_umax)、足向峰值流速(Vd_max)均低于术前（P<0.05）。结论Arnold-Chiari畸形患者经外科手术治疗可有效改善预后并提高生活质量,但行枕大池重建术时要注意防范脑脊液漏的发生,而Cine PC-MRI技术可为Arnold-Chiari畸形患者手术治疗疗效评估提供有效依据。更多还原

【Abstract】 Obective To explore the application of Cine PC MRI technology in the evaluation of surgical efficacy for cerebellar tonsil hernia（Arnold Chiari） malformation.Methods 65 patients with Arnold Chiari malformation undergoing surgical treatment collected from multiple centers from August 2018to September 2022.were selected as the research subjects.All patients were followed up for 6months after surgery.The prognosis,quality of life,atlantodontoid distance（ADI） value,diameter of spinal cord cavity,posterior fossa slope length,transverse diameter of foramen magnum,length of posterior fossa height,and cerebrospinal fluid flow of patients before and 6 months after surgery,and investigate the complications during the follow-up period were compared.Results 6 months after surgery,the scores of chicago chiari outcome scale（CCOS） and health related quality of life（HRQoL）of the patient were higher than before surgery（P<0.05）;During the follow-up period,there were 3patients who underwent reconstruction of the occipital cistern who experienced cerebrospinal fluid leakage from their wounds and were treated with lumbar cistern drainage.After 7 d,the wounds healed well.6 months after surgery,the value of atla ntoodontoid distance（ADI） and spinal cord cavity diameter of patient were lower than before surgery;The length of the posterior fossa slope and the height diameter of the posterior fossa were longer than before surgery;The stroke output（SV） and mean flow rate（MF） at the level of pontomedullary cistern,the level of midbrain aqueduct,and the level of cervical disc were all higher than before surgery;The peak head flow velocity(V_umax) and foot peak flow velocity(V_dmax) were lower than before surgery（P<0.05）.Conclusion Surgical treatment for Arnold Chiari malformation patients could effectively improve prognosis and improve quality of life.However,attention should be paid to preventing cerebrospinal fluid leakage during occipital cistern reconstruction surgery,and Cine PC-MRI technology could provide an effective basis for evaluating the surgical treatment effica cy of Arnold Chiari malfo rmation patients.更多还原