磁共振2D-PC cine法监测外伤后脑脊液循环动力学改变

Changes of cerebrospinal fluid circulation dynamics after cerebral trauma monitored with MRI 2D-phase contrast cine

目的运用MRI二维相位对比序列(2D-PC cine)法监测外伤后脑脊液动力学的改变。方法采用MRI 2D-PC cine法序列,以编码流速20 cm/s,于枕骨大孔水平测量40例健康志愿者与40例脑外伤后临床怀疑脑循环动力学异常患者的脑脊液流速、流量,并与腰穿结果相对照,比较两组脑脊液流速、流量之间有无差异。结果外伤组平均流速为1.100(0.895～1.420)cm/s,一个心动周期内净流量为0.073(0.017～0.124)ml,正常组平均流速为1.306(1.210～1.360)cm/s,一个心动周期内平均净流量为0.081(0.062～0.258)ml。外伤组平均流速及净流量均小于对照组(P<0.05)。结论 MRI 2D-PC cine能早期无创的发现脑外伤后颅内压增高患者脑脊液流体动力学的改变,对于脑外伤后患者脑脊液循环改变的监测、治疗及预后评价有重要指导意义。

Objective To evaluate the application of MRI 2D-phase contrast cine technique（MR 2D-PC cine） in monitoring the changes of cerebrospinal fluid（CSF） circulation dynamics.Methods MR 2D-PC cine was performed in 40 cases which were considered to have changes in CSF circulation dynamics and 40 healthy volunteers.The average velocity and the net forward volume of CSF were measured and compared with the results measured by lumbar puncture.Results In cerebral trauma patients,the average velocity was 1.100（0.895~1.420）cm/s and the net forward volume was 0.073（0.017~0.124） ml in a cardiac cycle.In healthy volunteers,the average velocity was 1.306（1.210~1.360）cm/s and the forward volume was 0.081（0.062~0.258）ml in a cardiac cycle.The average velocity of CSF in cerebral trauma patients was slower（P0.05） and net forward volume was less（P0.05） than that in volunteer.Conclusion MR 2D-PC cine can quantitatively monitor the changes of CSF circulation after trauma and provide evidence for clinical treatment.