应用磁共振相衬技术对ChiariⅠ型畸形合并脊髓空洞症的脑脊液动力学研究  

Study on the applicaton value of the PC-MRI on the cerebrospinal fluid dynamics in Chiari malformation typeⅠcomplicated with syringomyelia

作　　者：张鹏[1] 郑红绪 张少军[1] 韩易[1] ZHANG Peng;ZHENG Hong-xu;ZHANG Shao-jun;HAN Yi(Department of Neurosurgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院神经外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2021年第5期602-605,共4页Journal of Bengbu Medical College

基　　金：安徽省蚌埠市科技创新项目(201902)。

摘　　要：目的:应用磁共振相衬技术评估脑脊液动力学改变对ChiariⅠ型畸形脑脊液动力学的影响。方法:选取ChiariⅠ型畸形合并脊髓空洞症病人17例(CMⅠ组)和同期健康志愿者16名(对照组)为研究对象,病人均行后颅窝减压术,并于术前及术后12个月分别针对颅颈交界区行磁共振相衬技术检查,志愿者仅检查一次,分析中脑导水管中央段、第四脑室出口段及第二颈椎水平脑脊液流速、流量等参数的改变。结果:与对照组比较,CMⅠ组病人各被检处脑脊液峰流速均增快(P<0.05~P<0.01),且总体流量减少(P<0.01)。病人术后各处流速较术前明显变缓(P<0.01),流量增加(P<0.01)。不同预后病人的中脑导水管中段脑脊液流量、流速和第二颈椎腹侧脑脊液流速差异均有统计学意义(P<0.05~P<0.01)。结论:Chiari畸形Ⅰ型伴脊髓空洞症病人存在脑脊动力学变化,表现为脑脊液流动受阻,而脑脊液动力学的改善与病人预后具有相关性,应用磁共振相衬技术监测脑脊液动力学变化有助于评估病人预后。Objective:To explore the effects of the cine phase-contrast magnetic resonance imaging(PC-MRI)in evaluating the change of dynamics of cerebrospinal fluid(CSF)on the CSF dynamics in patients with Chiari malformation typeⅠ(CMⅠ).Methods:Sixteen healthy volunteers and 17 CMⅠand syringomyelia patients were divided into the control goup and CMⅠgroup,respectively.The region between canium and neck of CMⅠgroup was detected using PC-MRI scans before and after 12 months of operation,and the control group was checked only once.The changes of CSF velocity and flow at the central segment of midbrain aqueduct,exit segment of the fourth ventricle and second cervical spine level were analyzed.Results:Compared with the control group,the peak flow velocity of CSF in each examined site in CMⅠgroup increased(P<0.05 to P<0.01),and the overall flow decreased(P<0.01).After operation,the peak velocity of CSF in CMⅠgroup slowed significantly down(P<0.01),and the flow increased(P<0.01).The differences of the peak flow velocity and flow of CSF between the central segment of midbrain aqueduct and second cervical spine level among different prognosis patients were statistically significant(P<0.05 to P<0.01).Conclusions:The improvement of CSF dynamics is related to the prognosis of patients.The application of PC-MRI in monitoring the dynamics of CSF is helpful to evaluate the prognosis of patients with CMⅠcomplicated with syringomyelia.

关 键 词：Chiari畸形Ⅰ型 脊髓空洞症 磁共振相衬技术 脑脊液动力学 

分 类 号：R651[医药卫生—外科学]