脑脊液电影在神经内镜下三脑室底部造瘘脑脊液动力学改变中的应用

Using MR PC cine to evaluate CSF dynamics in neuroendoscopic third ventriculostomy：an analysis of 146 cases

目的 探讨脑脊液电影在神经内镜下第三脑室底部造瘘术前后引起的脑脊液动力学方面改变.方法 本组病例共146例经CT和核磁共振证实为脑积水,给予内镜下三脑室底部造瘘术.其中随机选取36例进行脑脊液电影检查（磁共振相位对比电影法）,判断造瘘术前后脑脊液动力学变化.同时在3个月至1年随访中应用脑脊液电影进行评价.结果 146例病人均成功进行了内镜下第三脑室底部造瘘术,其中121例（83%）术后症状明显好转.比较术前术后的脑脊液电影检测,显示脑室缩小、造瘘口流速、流量正常,脑脊液流动通畅.病人出院后随访表明症状明显改善的占110例（75.3%）.结论 利用脑脊液电影评估神经内镜下第三脑室底部造瘘术的疗效,可以定量分析脑脊液动力学改变,为评价脑积水治疗提供客观依据.

Objective To evaluate the change of CSF dynamics using MR PC Cine for neuroendoscopic third ventriculostomy.Methods 146 cases of hydrocephalus were treated by neuroendoscopic third ventriculostomy including 36 cases checked with MR PC Cine study randomly.The successful result was assessed by clinical symptom and imaging study.All the patients were given 3 mouthes to 1 year followup.Results The symptoms of 121 （83%） patients were recovered soon.CT,MRI and MR PC Cine demonstrated the CSF velocity,flow rate and dynamics change to the normal level compared with preoperative check.The effective rate of this group was 75.3% with one year follow-up.Conclusion The method of MR PC Cine to evaluate the CSF dynamics result for neuroendoscopic third ventriculostomy is simple,fast and safe.It is worth the clinical application.