Investigative Magnetic Resonance Imaging

  • 제17권2호
  • /
  • Pages.149-153
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  • 2013
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  • 2384-1095(pISSN)
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  • 2384-1109(eISSN)
대한자기공명의과학회 (Korean Society of Magnetic Resonance in Medicine)
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자기공명척수조영술을 이용한 수술 후 척추 뇌수막액 누출 평가

Detection of Surgery-related Spinal Cerebrospinal Fluid Leakage Using Magnetic Resonance Myelography

  • 구현정 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 김상준 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 정선주 (울산대학교 의과대학 서울아산병원 신경과) ;
  • 임승철 (울산대학교 의과대학 서울아산병원 신경외과)
  • Koo, Hyun Jung (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Sang Joon (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Chung, Sun J. (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Rhim, Seung-Chul (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2012.11.21
  • 심사 : 2013.01.30
  • 발행 : 2013.06.30
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초록

척추 수술의 합병증으로 뇌척수액 누출이 발생할 수 있는데 이를 영상학적으로 진단하는 것은 어려움이 있다. 이 연구에서는 자기공명척수조영술을 이용하여 척추 수술 후 뇌척수액 누출을 확인하였던 두 환자의 증례를 보고하고자 한다. 두 환자는 각기 요추 추간판 절제술과 척추 수막종 제거술을 받은 뒤 심한 두통을 호소하였다. 두 환자의 자기공명척수조영영상에서 척추 뇌수막액 누출 부위가 확인되었고, 이에 대해 환자들은 각각 epidural blood patch와 재수술을 받았다. 이 두 사례에서 자기공명척수조영술은 척추 뇌수막액의 누출 부위를 정확히 보여주었고, 척수강과 가성수막류 (pseudomeningocele) 사이의 교통로를 잘 나타내주었다. 척수 수술 후 뇌수막액 누출을 확인하기 위한 검사로 자기공명척수조영술이 유용한 것으로 생각된다.

Detection of cerebrospinal fluid leakage or exact localization of leakage site after spinal surgery is difficult on conventional imaging studies. We report two patients with surgery-related spinal CSF leakage detected on magnetic resonance (MR) myelography. They presented with severe headache after spinal surgeries, lumbar discectomy and excision of spinal meningioma, respectively. The sites of spinal CSF leakage in the patients were detected accurately on MR myelography, and the patients recovered from the postoperative CSF leakage after being treated with an epidural blood patch or reoperation. MR myelography may be effective in demonstrating the exact site of surgery-related spinal CSF leakage.

키워드

참고문헌

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