Correlation Research Of Scoliosis MRI Features And Relationships Between Risk Factors And MRI Positive Fingdings

Scoliosis is one of the common spine diseases in adolescent,whose incidenct rate is 1%~3%. The idiopathic scoliosis make up70%~80% in all the cases. Pathogensy is not identified. It is so hard todiagnose early that the malformation usually seems obvious. And asvertebral lesions is so complicated that it is very hard to operate anddeal with. And the operation pay so much attention to deal with themalformation, neglect the status of spinal cord, which makes theprognosis of scoliosis is very poor. So it is very hard to deal withdiagnosis and therapy. Retrospectively analysis are performed in 46cases with scoliosis, with imagiology and operation results, to provideinformation for clinical and therapy.The idiopathic scoliosis holds 36 cases (79%), the congenitalscoliosis 3 cases (6.5%), Neural-muscular scoliosis holds 2 case(4.35%), others make up 5 cases (10.87%).The vertebral abnormality sign of MRI is lateral curvature, asseen in traditional X-ray clearly. MRI is domminant position for thevertebral canal lesions. 18(39.1%) of the 46 cases had a positiveMRI. The common abnormalities of scoliosis include: 1 ,syringomelia, which is one of the most sign. Of these 46 cases, 1patient (5.6%) had syringomelia, 8 patients (44.4%) had syringomeliaand Arnold-Chiari malformation, whose MRI signal is low signaldensity on T1WI, high signal density on T2WI. 2,Arnold-Chiarimalformation: Chiari Ⅰinclude that cerebellar tonsil move downand pass the great occipital foramen for 5mm, but the fourth ventriclelie in the normal position, which made up 7 cases (38.9%). ChiariⅡinclude that cerebellar tonsil move down and pass the great occipitalforamen, with the fourth ventricle lengthened. Meningomyelocele isseen usually and found early. 1 patient (5.6%) had this malformation;all these 8 patients associated with syringomelia. 3,Tethered cordsyndrome: The medullary cone lies below the L4 level. There are 2cases (11.1%) with tethered cord syndrome. 4,Diastematomyelia: Thespinal cord is divided by fibrous tissues, whose sigal is low signaldensity on both T1WI and T2WI. 2 cases with diastematomyelia allaccompany with tethered cord syndrome. 5,The spinal cord tumors:1case(5.6%) is scoliosis with neurofibromatosis, whose mass ismuscular signal density on T1WI and little high singal density onT2WI; 2 cases (11.1%) is scoliosis with lipoma, whose mass is highsignal density on both T1WI and T2WI. 6,Meningocele: 1 case (5.6%)is scoliosis with meningocele, whose spinal meninges protruded onlycovered with skins.Association between the patients characteristics with scoliosisand positive MRI results 18 (39.1%) of 46 patients had a positive MRI.3 (30%) of 10 male and 15 (41.7%) of 36 female patients had positiveMRI.Relationships between single risk factors and MRI findings1,Early-onset scoliosis. As knowed generally, 20% of allpatients below 10 years old with scoliosis have a positive MRI finding,but in the cases reported by Araiet al, most patients had nervoussystem abnormality. 12 of 28 having no nervous system abnormalityhad positive MRI finding. 2,Severe curve despite immaturity. There is a high positiveMRI rate when curves >45°despite immaturity. 6 of 7 patients below11 years old with curves >45°despite immaturity had a positive MRIfinding. 3,Atypical curve pattern. Left thoracic type curve patternshould be suggestive of underlying neurogenic pathlolgy, which havehigher positive MRI findings if combined by neurologic changes or asevere curve despite immaturity. 6 of 10 patients with the left thoraciccurve pattern. 4 ,Rapidly progressive curve. Normally, idiopathic curvesprogress no >1°per month. 1 patient with scoliosis without neurologicsigns that progressed 19°in only 3 months. 6 of 9 patients with rapidlyprogressive curve had a positive MRI finding. 5,Abnormal neurologic findings. It is mandatory that cliniciansperform a thorough neurologic examination in every patient presentingwith scoliosis to detect subtle neurologic abnormalities. In rare cases,scoliosis may be the only presenting problem. However, if a subtleneurologic sign is detected and an MRI is obtained, syringomyelia orArnlod-Chiari malformations will theoretically not be missed. Theimportance of the superficial abdominal reflex cannot be...