第三脑室底造瘘术后瘘口区脑脊液流动的MRI定量研究  

MRI quantitative study of cerebrospinal fluid flow in ventage zone after endoscopic third ventriculostomy

作　　者：岳云龙[1] 刘洪亮[1] 金延方[1] 龚建伟[2] 吴晓华[3] 张奇瑾[1] 李滨[1] 胡志强[4] 

机构地区：[1]首都医科大学附属北京世纪坛医院放射中心,100038 [2]北京理工大学机械与车辆工程学院,100081 [3]首都医科大学附属北京友谊医院放射科,100050 [4]首都医科大学附属北京世纪坛医院神经外科,100038

出　　处：《中国微侵袭神经外科杂志》2011年第7期294-298,共5页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：北京世纪坛医院科研基金(编号:2008-16;2009-23)

摘　　要：目的应用磁共振相位对比电影成像(Cine PC MRI)对第三脑室底造瘘术(ETV)后瘘口区脑脊液流动情况进行定性及定量分析。方法对15例因中脑导水管狭窄或闭塞行ETV的病人,行Cine PC MRI检查(研究组),并选择15名正常志愿者作为对照组。观察瘘口区脑脊液流动情况,测量并计算瘘口区的收缩期最大流速(MSV)、舒张期最大流速(MDV)、平均流率(AFR)及1个心动周期脑脊液搏动量(SV)、净流量(NV);并对两组参数进行比较。结果研究组瘘口区脑脊液流动表现为与对照组导水管区相似的双向搏动。研究组脑脊液进入收缩期时间点为(35.52±10.26)%,对照组为(24.47±7.64)%;研究组脑脊液达到MSV时间点为(54.89±12.8)%,对照组为(42.95±10.88)%;研究组SV为(121.27±75.97)μl,对照组为(41.77±20.05)μl;研究组AFR为(20.79±10.16)ml/min,对照组为(7.28±2.42)ml/min;以上参数两组差异均具有统计学意义(P<0.05)。而两组脑脊液收缩期占心动周期的百分比、MSV及MDV差异均无统计学意义(P>0.05)。结论 Cine PC MRI可对ETV后瘘口区脑脊液流动行定性、定量分析。瘘口区收缩期较正常导水管区滞后,但SV和AFR明显大于正常导水管区。Objective To qualitatively and quantitatively analyze cerebrospinal fluid（CSF） flow in ventage zone after endoscopic third ventriculostomy（ETV） by cine phase-contrast magnetic resonance imaging（Cine PC MRI）.Methods Fifteen patients undergoing ETV because of aqueductal stenosis or obstruction were enrolled as research group and 15 healthy volunteers as control group,both the groups received Cine PC MRI.Qualitative evaluation of CSF flow was made,and quantitative analysis such as maximal systolic velocity（MSV）,maximal diastolic velocity（MDV）,average CSF flow rate（AFR） and stroke volume（SV） and net volume（NV） per cardiac cycle were measured and recorded.The parameters of two groups were compared.Results The CSF flow in the ventage zone of research group presented bidirectional pulsate,which was similar to the aqueduct zone of control group.The time point of entering systole was 35.52±10.26% in research group and 24.47±7.64% in control group,the time point of reaching MSV was 54.89±12.8% in research group and 42.95±10.88% in control group.SV was 121.27±75.97μl in research group and 41.77±20.05μl in control group,AFR was 20.79±10.16ml/min in research group and 7.28±2.42ml/min in control group,there was a statistical significance in the difference between the two groups（P0.05）.There were no statistical significance in the difference of MSV,MDV and the percentage of CSF systole in the cardiac cycle between the groups（P0.05）.Conclusions Cine PC MRI is an efficient technique for make the qualitative and quantitative analysis of the CSF flow in the ventage zone after ETV.Compared with the normal aqueduct,there is a time lag of systole in ventage zone,but SV and AFR in the ventage zone are larger than those in normal aqueduct.

关 键 词：脑积水 脑室造口术 磁共振成像 电影 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]