青少年Chiari畸形脑脊液流动状态的临床研究

Clinical study of cerebrospinal fluid flow in Chiari malformation

目的检测Chiari畸形枕颈交界区蛛网膜下腔脑脊液流动状态。方法对7例Chiair畸形病人(年龄10～20岁),行常规脑脊髓磁共振(MRI)检查,同时采用MRI相位对比电影法检测C2椎体下缘水平椎管内蛛网膜下腔脑脊液向下最大流速(MSV)、向上最大流速(MDV)、向下流动所占据整个流动周期比例(SFR)、向上流动所占据整个流动周期比例(DFR)和静止期比例。以7例年龄匹配正常人作为对照组,检测方法相同。结果与正常对照组比较,Chiari畸形脑脊液流动状态发生改变,脑脊液流速减慢,SFR明显缩短,静止期比例延长(P<0.05)。结论Chiari畸形病人C2处椎管内脑脊液流速减慢,相对静止期延长,提示脑脊液流动状态与Chiari畸形的病理生理改变有关。

Objective To determine the flow patterns of cerebrospinal fluid （CSF） in subarachnoid space at the level of the occipital-cervical junction in Chiari malformation. Methods Seven patients at the age of 10-20 years old with Chiari malformations were examined for the brain and spinal cord by magnetic resonance imaging （MRI）, meanwhile, for the maximum systolic velocity （MSV）, systolic cycle flow ratio （SFR）, diastolic cycle flow ratio （DFR）, and the ratio of quiescent period of CSF in the spinal subarachnoid space at the level of lower edge of C2 vertebral body by cine phase-contrast MRI. Seven age-matched healthy persons were served as control group. Results Compared with the control group, the CSF .flow was slowed, SFR was shortened, and quiescent period prolonged in the Chiari malformation patients （P〈0.05）. Conclusion The CSF flow is slowed and relative quiescent period prolongs at the C2 level in Chiari malformation patients, suggesting the flow pattern of CSF may correlate with the pathophysiological change in Chiari malformation.