A Cervical Flexion-Extension MRI Study in Down Syndrome

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• 作者：Andrea Romano (1)
  Giorgio Albertini (2)
  Danilo Guida (3)
  Riccardo Cornia (4)
  Cristina Settecasi (5)
  Claudia Condoluci (2)
  Marta Moraschi (1)
  Luigi Maria Fantozzi (3)
  Alessandro Bozzao (3)
  Alberto Pierallini (5)
  
  1. San Raffaele Foundation Rome ; Rehabilitation Facility Ceglie Messapica ; Progetto Merit RBNE08E8CZ ; Via della Pisana 235 ; 00163 ; Rome ; Italy
  2. IRCSS San Raffaele Pisana ; Department of Pediatrics ; Rome ; Italy
  3. NESMOS ; Department of Neuroradiology ; S. Andrea Hospital ; University Sapienza ; Rome ; Italy
  4. Department of Neurosciences ; University of Modena and Reggio Emilia ; Corso Canal Grande ; 64 ; Modena ; Italy
  5. IRCSS San Raffaele Pisana ; Department of Radiology ; Rome ; Italy
  
• 关键词：Down syndrome ; MRI ; Craniocervical instability ; Anterior subarachnoidal space
• 刊名：The Indian Journal of Pediatrics
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：82
• 期：4
• 页码：349-353
• 全文大小：489 KB
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• 刊物主题：Pediatrics; Gynecology;
• 出版者：Springer India
• ISSN：0973-7693

文摘

Objective To assess what kind of information MR examination in flexed and extended positions provides in Down syndrome subjects with suspected cranio-cervical instability. Methods Between 2005 and 2008, 35 subjects with DS were recruited in the study. Ethics committee approval was granted and a signed informed consent was obtained from the parents. All the subjects were affected by hypotonic status and ligament laxity established by clinical evaluation, but were asymptomatic about focal neurological symptoms due to medullar damage caused by cranio-cervical instability. Each patient underwent lateral supine radiographs and MR imaging in the neutral, active flexed and extended positions. For evaluating the atlanto-axial and atlanto-occipital joint stability, multiple measurements were calculated. Results A significant reduction of anterior subarachnoid space in flexed position was evident in DS subjects compared to healthy controls in neutral and flexed positions. Both, space available for cord and ligamentous thickness showed significant differences between DS subjects and healthy controls. In DS subjects with occipito-cervical instability, the anterior subarachnoidal space reduction was significantly reduced in flexed position. Conclusions In DS subjects with asymptomatic cranio-cervical instability, anterior subarachnoidal evaluation and ligamentous status could add new information about the risk of spinal cord damage.