低颅压综合征的MR诊断及征象分析  

MR diagnosis and analysis of signs of intracranial hypotension syndrome

作　　者：张存美[1,2] 王光彬[2] 武乐斌[2] 刘玉波[3] 赵连新[1,2] 史宏璐[1,2] 杨丽[1,2] 

机构地区：[1]山东大学医学院,山东济南250012 [2]山东省医学影像学研究所 [3]山东省立医院

出　　处：《实用放射学杂志》2014年第3期378-381,共4页Journal of Practical Radiology

摘　　要：目的 分析低颅压综合征（intracranial hypotension syndrome，IHS）的MRI表现，提高对该病的影像学诊断。方法 回顾性分析19例IHS患者的临床及MRI资料。所有患者均行颅脑MR平扫及增强扫描，其中，行颅脑MRA 7例，MRV 8例，SWI 8例，脊椎MR增强扫描3例。结果 16例IHS患者存在体位性头痛；12例患者行腰椎穿刺术，10例脑脊液压力＜60 mmH2O，2例正常；颅脑MRI主要表现为硬脑膜弥漫性对称性增厚并强化（19/19）、脑组织移位、静脉窦及脑静脉扩张（17/19）、脑室变窄（12/19）、硬膜下积液（6/19）、硬膜下血肿（2/19）、垂体增大；3例脊椎MR增强扫描见硬脊膜弥漫性强化。结论 体位性头痛及硬脑膜弥漫性对称性增厚并强化是IHS的特征性表现。MR增强扫描联合应用MRV对IHS诊断具有重要价值。Objective To explore the MRI features of intracranial hypotension syndrome （IHS） and improve the imaging diagnosis of this uncommon disease. Methods The clinical and MR findings of 19 patients with IHS were analyzed retrospectively. All pa- tients underwent pre-and post-contrast brain MRI. Among the 19 cases,brain MRA were performed in 7 cases, MRV were performed in 8 cases and SWI in 8 cases,spinal enhanced MRI were performed in 3 cases. Results 16 patients had typical orthostatie headache. 12 patients had lumbar puncture,the opening cerebrospinal fluid pressure was low （~60 mmH2（）） in 10 patients and above normal in the remaining 2 patients. Brain MRI abnormalities included dural thickening and homogeneous enhancement（19/19）, downward displacement of the brain, engorgement of venous structures（17/19） , shrinkage of ventricle size（12/19）, subdural fluid collections （6/19）, subdural hematomas（2/19）, enlargement of pituitary. Post-contrast spinal MRI showed spinal meningeal enhancement in 3 cases. Conclusion Orthostatie headache with typical findings on MRI are the key to diagnosis. Enhanced MRI and MRV have significant diagnostic value on IHS.

关 键 词：颅内低压 磁共振成像 体位性头痛 

分 类 号：R544[医药卫生—心血管疾病] R445.2[医药卫生—内科学]