交通性脑积水脑室分流前后的脑脊液MRI定量研究

MRI Quantitative CSF Study in Communicating Hydrocephalus before and after VP Surgery

目的:运用 MRI cine PC定量研究交通性脑积水脑室分流前后的脑脊液流动情况。材料和方法:在1.5T GEHorizon Signa磁共振机器上利用MRI cine PC程序,在以前实验所得的液体流速与信号强度关系公式的基础上,对16例交通性脑积水的中脑导水管、枕大孔和C2水平脑脊液流速、流量情况进行MRI cine PC检查(1.5TGE Horizon Signa),并对其中10例交通性脑积水脑室引流后的中脑导水管和枕大孔处脑脊液的流速和流量同样进行测量,并与术前进行比较。同时作为对照,对31例正常志愿者颅内中脑导水管、枕大孔和C2水平的脑脊液流速和流量进行测定。结果:交通性脑积水中脑导水管水平脑脊液流速和流量明显增快,与正常者进行统计有明显差异(P<0.05),向下峰速和向上峰速分别为47.57±16.71mm/s和44.48±19.22mm/s,向下流量及向上流量明显增大为3.142±1.055ml/s及3.143±1.055ml/s;脑脊液净流量为0±0.003ml/s。而枕大孔向下峰速和向上峰速分别为1.37±0.44mm/s和1.33±0.41mm/s,向下流量及向上流量分别为0.351±0.125ml/s及0.350±0.12lml/s;脑脊液净流量为0.001±0.007ml/s。C2水平脑脊液向下峰速和向上峰速分别为2.41±1.27mm/s和2.95±1.15mm/s,向下流量及向上流量分别为0.521±0.214ml/s和0.519±0.214ml/s;

Purpose: To study the flow of cerebrospinal fluid(CSF) in patients with communicating hydrocephalus pre and post surgery with MRI in phase contrast cine mode(MRI cine PC) .Materials and Methods: A 1. 5T GE Horizon Signa MRI was used in the study. On the basis of the experiment result, CSF flow at the level of aqueduct, foramen magnum and C2 was examined in 16 cases with communicating hydrocephalus, in which 10 of them were measured quantitatively pre and post VP surgery.In contrast to the normal, 31 normal volunteers were examined with the same methods.Results: In the aqueduct of patients with communicating hydrocephalus the flow velocity and quantity were much higher than that of normal vol-unteersO < 0.05), the outflow and inflow peak velocity were 47.57± 16.71mm/s and 44.48 ± 19.22mm/s respectively, and the quantities of outflow and inflow were 3.142 ± 1.055ml/ s and 3.143 ± 1.055ml/ s re- spectively, and the magnitude range of CSF was 0 ± 0.003ml/ s. At the level of foramen magnum the outflow and inflow peak velocity were 1.37± 0.44mm/s and 1.33± 0.41mm/s respectively, the quantities of outflow and inflow were 0.351 ± 0.125ml/s and 0.350 ± 0.121ml/s respectively, and the magnitude range of CSF was 0.001 ± 0.007ml/ s.At the level of C2 the outflow and inflow peak velocity were 2.41 ± 1.27mm/ s and 2.95 ± 1.15mm/ s respectively, and the quantities of outflow and inflow were 0.521 ± 0.214ml/s and 0.519± 0.214ml/s respectively,and the magnitude range of CSF was 0.002 ± 0.003ml/s. In 10 patients with communicating hydrocephalus whose symptoms were relieved after VP surgery compared to that before the VP operation, the CSF flow velocity and quantities in the aqueduct were decreased significantly(P < 0.05) .Conclusion: MRI cine PC is a noninvasive method to study the CSF flow in the physiological and pathological conditions, better than other invasive research modalities and helpful in the diagnosis and differential diagnosis of communicating and obstructive hydrocephalus.