3D-CISS序列在儿童脑积水术前诊断中的应用

Application of 3D-CISS sequences in preoperative diagnosis of hydrocephalus in children

目的研究MRI三维稳态构成干扰序列(3D-CISS)在诊断儿童脑积水膜性梗阻方面的作用。方法 41例脑积水病儿术前均行MRI检查,包括常规序列和3D-CISS序列。比较3D-CISS序列与常规序列在诊断脑室、脑池膜性梗阻方面的差异,分析两种序列在诊断脑积水方面是否存在差异。结果 MRI常规序列诊断交通性脑积水29例,非交通性脑积水12例;3DCISS序列诊断交通性脑积水25例,非交通性脑积水16例;两种序列在诊断脑积水方面差异无统计学意义(P>0.05)。41例病儿中,经3D-CISS序列评估后选择脑室镜手术18例,包括非交通性脑积水16例,及存在脑池膜性梗阻的交通性脑积水2例;这18例随访半年以上,均未发现脑积水复发。结论 3D-CISS序列可清晰显示脑积水病人脑室内及脑室外的膜性梗阻,有助于对病人进行准确分类,指导选择合适的手术方案。

Objective To investigate the function of 3D-constructive interference in the steady state （3D-CISS） in the diagnosis of membranous obstruction in children with hydrocephalus. Methods MRI examination was performed in 41 patients with hydrocephalus, including conventional and 3D-CISS sequences. The differences in diagnosing membranous obstruction of the cistern and ventricle between 3D-CISS and conventional sequences were compared, and the difference in diagnosing hydrocephalus between the two sequences was analyzed. Results Twenty-nine communicating hydrocephalus and 12 non-communicating hydrocephalus were found by conventional sequence, while 25 communicating hydrocephalus and 16 noncommunicating hydrocephalus were found by 3D-CISS, and there was no statistical difference between the two sequences in diagnosing hydrocephalus （P〉0.05）. Among the 41 patients, the surgery with ventriculoscope was selected in 18 patients after the assessment by 3D-CISS, including 16 non-communicating hydrocephalus and 2 communicating hydrocephalus with membranous obstruction of the cistern. Eighteen patients were followed more than half year, no hydrocephalus recurred. Conclusions 3D-CISS sequence can clearly show the membranous obstruction of inside and outside ventricle in patients with hydrocephalus, which can help to exactly classify the type of hydrocephalus and choose the suitable surgical plan.