RESUMO
Spinal cord signal abnormality resulting from alterations in cerebrospinal fluid flow at the craniocervical junction has been termed a presyrinx state. This condition has been described in the adult literature in association with a variety of conditions that cause obstruction to normal cerebrospinal fluid flow. We present a case of presyrinx in a child in the setting of acquired Chiari I malformation caused by lumboperitoneal overshunting. Awareness of the potentially reversible nature of this condition might allow for intervention before irreversible neurological damage has occurred.
Assuntos
Malformação de Arnold-Chiari/patologia , Malformação de Arnold-Chiari/cirurgia , Derivações do Líquido Cefalorraquidiano , Edema/patologia , Edema/cirurgia , Siringomielia/patologia , Siringomielia/cirurgia , Humanos , Lactente , Masculino , Resultado do TratamentoAssuntos
3-Iodobenzilguanidina , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neuroblastoma/diagnóstico por imagem , Órbita/diagnóstico por imagem , Neoplasias Orbitárias/diagnóstico por imagem , Animais , Humanos , Lactente , Masculino , Guaxinins , Cintilografia , Compostos RadiofarmacêuticosRESUMO
PURPOSE: To compare nongated three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CE-MRA) with 3D-navigated cardiac-gated steady-state free-precession bright blood (3D-nav SSFP) and noncontrast 2D techniques for ascending aorta dimension measurements. MATERIALS AND METHODS: Twenty-five clinical exams were reviewed to evaluate the ascending aorta at 1.5T using: breathhold cine bright blood (SSFP), cardiac-triggered T2 black blood (T2 BB), axial 3D-nav SSFP, and nongated 3D CE-MRA. Three radiologists independently measured aortic size at three specified locations for each sequence. Means, SDs, interobserver correlation, and vessel edge sharpness were statistically evaluated. RESULTS: Measurements were greatest for 3D-nav SSFP and 3D CE-MRA and smallest for T2 BB. There was no significant difference between 3D-nav SSFP and 3D CE-MRA (P = 0.43-0.86), but significance was observed comparing T2 BB to all sequences. Interobserver agreement was uniformly >0.9, with T2 BB best, followed closely by 3D-nav SSFP and 2D cine SSFP, and 3D CE-MRA being the worst. Edge sharpness was significantly poorer for 3D CE-MRA compared to the other sequences (P < 0.001). CONCLUSION: If diameter measurements are the main clinical concern, 3D-nav SSFP appears to be the best choice, as it has a sharp edge profile, is easy to acquire and postprocess, and shows very good interobserver correlation.
