成年单纯Chiari畸形Ⅰ型患者后颅窝骨性结构的形态学研究

王聖茜; 胡晓珺; 李洋; 夏永智; 晏怡

doi:10.16016/j.1000-5404.202006216

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成年单纯Chiari畸形Ⅰ型患者后颅窝骨性结构的形态学研究

临床医学 | 更新时间：2026-01-09

- 成年单纯Chiari畸形Ⅰ型患者后颅窝骨性结构的形态学研究
- Morphological study of bone structure of the posterior cranial fossa in adults with Chiari malformation type Ⅰ without basilar invagination
- 第三军医大学学报 2020年42卷第22期页码：2238-2243
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院神经外科
- 作者简介：
  
  [ 夏永智，E-mail: yongzhixia@aliyun.com XIA Yongzhi, E-mail: yongzhixia@aliyun.com
- 基金信息：
  
  国家临床重点专科建设项目(财社170号)
- DOI：10.16016/j.1000-5404.202006216
  中图分类号： R321.6;R323.1;R682.1
- 收稿：2020-06-22，
  
  修回：2020-07-15，
  
  纸质出版：2020-11-30
- 稿件说明：
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王聖茜, 胡晓珺, 李洋, 等. 成年单纯Chiari畸形Ⅰ型患者后颅窝骨性结构的形态学研究[J]. 第三军医大学学报, 2020,42(22):2238-2243.

Shengxi WANG, Xiaojun HU, Yang LI, et al. Morphological study of bone structure of the posterior cranial fossa in adults with Chiari malformation type Ⅰ without basilar invagination[J]. Journal of Third Military Medical University, 2020, 42(22): 2238-2243.
王聖茜, 胡晓珺, 李洋, 等. 成年单纯Chiari畸形Ⅰ型患者后颅窝骨性结构的形态学研究[J]. 第三军医大学学报, 2020,42(22):2238-2243. DOI： 10.16016/j.1000-5404.202006216.

Shengxi WANG, Xiaojun HU, Yang LI, et al. Morphological study of bone structure of the posterior cranial fossa in adults with Chiari malformation type Ⅰ without basilar invagination[J]. Journal of Third Military Medical University, 2020, 42(22): 2238-2243. DOI： 10.16016/j.1000-5404.202006216.

摘要

目的

探讨无颅底凹陷的成人单纯Chiari畸形Ⅰ型(Chiari malformation typeⅠ，CMⅠ)患者后颅窝骨性结构的变化。

方法

收集2018年1月至2020年6月我科收治的成人单纯CMⅠ患者作为观察组，选取性别、年龄匹配的健康体检者作为对照组，根据头颈薄层CT数据比较两组受试者后颅窝骨性结构线性、角度及面积参数的差异。

结果

两组分别纳入38例，观察组斜坡长(

0.001)、枕上长(

0.01)、枕骨长(

0.001)、Klaus高度指数(

0.001)、后方压迫值(

0.001)、小脑幕枕骨角(

0.05)和后颅窝矢状面面积(

0.001)均小于对照组，齿突压迫值(pBC2)(

0.01)、齿突软组织压迫值(

0.01)、前方压迫值(

0.001)和基底角(

0.01)均大于对照组，差异具有统计学意义。

结论

成人单纯CMⅠ斜坡及枕骨缩短并上抬，并伴有齿状突后缘骨质对延颈髓前方的压迫。

Abstract

Objective

To examine the morphological characteristics of the bone structure in the posterior cranial fossa in adult patients with Chiari malformation type Ⅰ (CMⅠ) without basilar invagination.

Methods

Thirty-eight adult patients with CMⅠ without basilar invagination treated in our department between January

2018 and June

2020 were enrolled in this study as the observation group

and 38 gender- and age-matched healthy adults served as the control group. The differences in the linear and angular variables in the posterior cranial fossa were analyzed between the 2 groups based on thin-slice CT data.

Results

Compared with the control subjects

the patients with CMⅠ showed significantly decreased clivus length (

0.001)

supra-occipital length (

0.01)

occipital length (

0.01)

Klaus height index (

0.001)

posterior compressive value (

0.01)

tentorial angle (

0.05) and sagittal area of the bony posterior cranial fossa (

0.001) and significantly increased odontoid compressive value (

0.01)

odontoid and soft tissue compressive value (

0.01)

anterior compressive value (

0.01) and basal angle (

0.01).

Conclusion

In adult patients with CMⅠ patients but without basilar invagination

the clivus and occipital bone are shortened and elevated with co-existing ventral cervicomedullary compression by the posterior margin of the odontoid process.

关键词

Keywords

references

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