磁共振水成像在自发性低颅压中的应用

The application of magnetic resonance hydrography in spontaneous intracranial hypotension syndrome

目的总结自发性低颅压综合征(spontaneous intracranial hypotension syndrome,SIHS)的磁共振水成像(magnetic resonance hydrography,MRH)的特点,并探讨MRH的临床应用价值。方法回顾性总结经临床确诊的10例SIHS的患者的临床资料、磁共振检查方法及其表现。结果 8例有硬脑膜弥漫性均匀性增厚,5例伴有硬膜下积液,增强后7例出现弥漫性硬脑膜强化,脊柱MR扫描10例有硬脊膜增厚,7例硬膜外间隙积液,磁共振脊髓水成像(Magnetic resonance myelography,MRM)7例发现漏口位置,1例显示两个漏口位于颈椎和腰椎,5例位于颈椎,1例位于腰椎。结论磁共振脊髓水成像能直接显示脑脊液漏的部位和形态,对SIHS确诊和针对漏口的手术治疗有重要的临床指导价值。

Objective To summary magnetic resonance hydrography characteristics of spontaneous intracranial hypotension syndrome （SIHS） and to explore the clinical appiication value of magnetic resonance hydrography. Methods 10 cases of SIHS in patients with clinical data, magnetic resonance imaging methods and performance were retrospectively reviewed. Results 8 cases showed diffusely thickening of dural, 5 cases presented with subdural hydroma and 7 cases on postcontrast MRI demonstrated diffusely dural enhancement. Spinal MR scanning showed 10 cases with thickening dural, 7 cases with epidural space effusion. Cerebrospinal fluid （CSF） leakage sites was shown in 7 cases using magnetic resonance myelography （MRM）, 1 patient showed two CSF leakage sites in cervical and lumbar spines, 5 patients in cervical spine, 1 patient in lumbar spine. Conclusion MRM could directly show the location and shape of cerebrospinal fluid leakage and provid important clinical value for the diagnosis of SIHS and outlet operation treatment.