特发性高颅压MRI征象分析

MRI features of idiopathic intracranial hypertension

目的分析特发性高颅压(ⅡH)的MRI征象,提高对该病的影像学诊断能力。方法收集临床确诊的17例ⅡH患者(ⅡH组)和同期性别、年龄相匹配的17名健康体检者(对照组),分析并比较2组巩膜后部、视神经鞘、蝶鞍及颅内静脉窦的MRI表现。结果ⅡH组与对照组间,双侧巩膜厚度、视神经鞘宽度、蝶鞍深度、静脉窦宽度差异均有统计学意义(P均<0.05)。根据巩膜后部变平诊断ⅡH的敏感度为41.18%(7/17)、特异度为100%(17/17),视神经鞘扩张的敏感度为82.35%(14/17)、特异度为94.12%(16/17),空蝶鞍的敏感度为70.59%(12/17)、特异度为82.35%(14/17),颅内静脉窦狭窄敏感度为94.12%(16/17)、特异度为88.23%(15/17)。结论根据视神经鞘扩张和颅内静脉窦狭窄诊断ⅡH具有较高的敏感度和特异度。正确认识ⅡH的MRI表现对早期诊断和治疗具有重要价值。

Objective To analyze MRI features of idiopathic intracranial hypertension(ⅡH),in order to improve MRI diagnostic ability of ⅡH.Methods Totally 17 patients with clinically diagnosed ⅡH(ⅡH group)and 17 healthy controls(control group)with matched age and gender were enrolled.MRI features,including the shape of posterior sclera,optic nerve sheath as well as sella and venous sinus were observed and compared between the two groups.Results There were significant differences of the depth of posterior sclera,optic nerve sheath,empty sella turcica and venous sinus between ⅡH group and control group(all P<0.05).The sensitivity and specificity of posterior sclera flatten was 41.18%(7/17)and100%(17/17),of optic nerve sheath distension was 82.35%(14/17)and 94.12%(16/17),of empty sella was 70.59%(12/17)and 82.35%(14/17),of venous sinus stenosis was 94.12%(16/17)and 88.23%(15/17),respectively.Conclusion Optic nerve sheath distension and venous sinus stenosis have high sensitivity and specificity,which are reliable MRI feature in diagnosis of ⅡH.Correct understanding of imaging features of ⅡH has important value for early diagnosis and treatment of ⅡH.