第三脑室造瘘术后脑脊液流通性MRI不同序列评估的对比研究

Comparative study to assess cerebrospinal fluid flow of post endoscopic third ventriculostomy by MRI

目的:应用MRI3D-CUBET2WI、三维稳态进动快速成像序列(3D-FIESTA)及相位对比MRI电影(PccineMRI)序列对神经内镜第三脑室造瘘术(ETV)术后患者造瘘口脑脊液通路进行评估,以比较3个序列间的差异及临床应用范畴,进一步实现ETV术后脑脊液评估的MRI个体化及最优化扫描。方法:应用3.0TMRI对12例经ETV治疗的梗阻性脑积水患者行颅脑MRI复查,并分别行矢状位3D-CUBET2WI、3D-FIESTA及轴位PccineMRI序列扫描。结果:7例3个序列对造瘘口是否通畅的诊断分级完全一致;4例检查中1种序列评估存在可疑病变,经3种序列综合评估,最终诊断为通畅,后期随访中得到证实;1例心率不齐无法完成PccineMRI者,经3D-CUBET2WI、3D-FIESTA序列诊断为通畅,并在后期随访中得到验证。结论:3D-CUBET2WI在ETV术后评估中是最简单、有效的序列,在复杂或可疑患者中3D-FIESTA和PccineMRI可作为补充序列。

Objective:To assess cerebrospinal fluid(CSF)flow in patients with endoscopic third ventriculostomy(ETV)by 3D-CUBE T2WI,3D-FIESTA and Pc cine MRI sequence,and to compare the differences and clinical applications between the three series,further realize the individualization and optimization MRI scan protocols for CSF evaluation with ETV patients.Methods:12 patients with obstructive hydrocephalus who were treated with ETV were examined by 3.0 T MRI,and the sagittal 3D-CUBE T2WI、3D-FIESTA and Pc cine MRI were scanned.Results:The diagnostic scores of fistulae in 7 patients were identical with that of unobstructed fistulae by 3 sequences.Among the 4 patients,one sequence was assessed with suspicious lesions,and the final diagnosis was unobstructed by the comprehensive evaluation of other three sequences,which was confirmed in the later follow-up.A patient with irregular heart rate who could not complete Pc cine MRI was confirmed after 3D-CUBE T2WI and 3D-FIESTA diagnosis.Conclusion:The 3D-CUBE T2WI sequence seems to be the simplest and most efficient one for determination of ETV patients,and the 3D-FIESTA and Pc cine MRI can be used as an effective complementary sequence in complex or suspicious cases.