ABSTRACT
Objective To investigate the mechanism and effect of the spinal cord outlet of the skull base on Chiari Ⅰ malformation with syringomyelia.Methods The cervical spinal cord stem angle (Anbc),slope angle of cervical vertebra (Ansc) of Chiari Ⅰ malformation were measured.In foramen magnum (Llf) and anterior vertebral canal level (Laf),spinal canal(Ac),spinal cord (As) and inferior hernia area (Ah) were measured.Angle,area and ratio were compared in Chiari Ⅰ malformation with syringomyelia,Chiari Ⅰ malformation without syringomyelia and normal control group.Results Ansc,Anbc-Ansc had significant differences among control group and Chiari Ⅰ malformation patients (all P＜0.001).In Llf,Laf,As had significant differences among three groups (all P＜0.05),further comparison of the two showed there were significant differences between Chiari Ⅰ malformation with syringomyelia patients and control group,Chiari Ⅰ malformation without syringomyelia patients and control group in Llf(all P＜0.05).In Llf,Laf,Ac in Chiari Ⅰ malformation with syringomyelia was smaller than control group (P＜0.05).Ah in Llf,Lafand Lh in Llf had no statistical significant difference between Chiari Ⅰ malformation with and without syringomyelia patients (all P＞0.05).In Llf,Laf,As/Ac had statistical significant difference among Chiari Ⅰ malformation with and without syringomyelia patients,control group (all P＜0.001),further comparison of the two showed As/Ac in Llf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group (P＜0.05),As/Ac in La had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group,between Chiari Ⅰ malformation without syringomyelia patients and control group (all P＜0.05),Conclusion The cervical spinal cord,Ansc reducing,narrow vertebral proportion increase are important factors to promote Chiari Ⅰ malformation syringomyelia.
ABSTRACT
Objective To evaluate the value of diffusion-weighted MRI ,time of flight MR angiography (TOF-MRA) and 3D dynamic contrast enhanced MR angiography (3D DCE-MRA) in the diagnosis of transient ischemic attacks(TIA). Methods 176 consecutive patients with TIA were undergone MRI, including FLAIR,DWI,TOF-MRA and 3D CE-MRA sequences. Results Of 176 cases,48.9% of patients were found having hyperacute ischemic lesions by DWI sequence and 18.2% of lesions could be detected by T2WI.TOF-MRA showed arterial stenosis and occlusion in 76 cases(43.2%),false positive rate and excessive diagnosis were happened in 20 cases.3D CE-MRA of brain showed arterial stenosis and occlusion in 69 cases(39.2%).3 cases with aneurysm and 2 cases with arteriovenous malformation were detected by two methods.3D CE-MRA of neck showed arterial stenosis and occlusion in 38 cases(21.6%).Conclusion DWI and MRA are helpful in detecting the hyperacute ischemic lesion and evaluating the arterial lesions in the patients with TIA.