钆喷酸葡胺MRI脑池造影在儿童颅内蛛网膜囊肿的诊断价值

Diagnostic value of gadopentetate dimeglumine-enhanced MRI cisternography for intracranial arachnoid cysts in children

目的研究以钆喷酸葡胺为造影剂的MRI脑池造影术在儿童颅内蛛网膜囊肿的诊断价值。方法回顾性分析13例颅内蛛网膜囊肿病人的临床资料。通过腰椎穿刺术或侧脑室穿刺术,将稀释后的钆喷酸葡胺注入蛛网膜下腔。造影前、注药后1 h和24 h分别进行MRI扫描,评估囊肿内外脑脊液交通情况。结果 13例病人中,造影后仅有1例出现一过性头痛,其他病人未出现明显的并发症。根据造影结果,囊肿早期显影10例,延迟显影1例,不显影2例。延迟显影和不显影的病人采取手术治疗,其他病人非手术治疗。随访13例,时间平均6.5个月,接受手术者蛛网膜囊肿的体积有缩小,非手术治疗的病人未出现囊肿增大。结论以钆喷酸葡胺为造影剂的MRI脑池造影对儿童颅内蛛网膜囊肿的诊断和治疗有重要的临床意义。

Objective To investigate the diagnostic value of gadopentetate dimeglumine-enhanced MRI cisternography in children with intracranial arachnoid cysts. Methods Clinical data of 13 children with intracranial arachnoid cysts were analyzed retrospectively. Diluted gadopentetate dimeglumine was injected into the subarachnoid space by lumbar puncture or ventricular puncture. The communication of cerebrospinal fluid between the inside and outside of cysts was examined by MRI before angiography,1 h and 24 h after the angiography. Results No serious complications related to angiography were observed. The transient headache was observed in 1 patient. According to angiography results, 10 of 13 arachnoid cysts showed immediate communication with the subarachnoid space, 1 delayed enhancement and 2 no enhancement. The patients with delayed enhancement and no enhancement cysts received surgery, and others did not receive surgical treatment. All the patients were followed up for a mean period of 6.5 months, the cysts shrunk after surgery and there was no enlargement in other cysts of patients who did not receive surgery. Conclusions Gadopentetate dimeglumine-enhanced MRI cisternography is of important clinical significance for the diagnosis and treatment of intracranial arachnoid cysts in children.