大脑脚脚间角对低颅压综合征患者的临床价值  

Brain MRI study of the interpeduncular angle in patients with intracranial hypotension

作　　者：冯结映 黄飚[3] 黄少飞 胡海菁 FENG Jie-ying;HUANG Biao;HUANG Shao-fei(Department of Radiology,Nanhai District People’s Hospital of Foshan,Guangdong 528200,China)

机构地区：[1]佛山市南海区人民医院放射科,广东佛山528200 [2]佛山市南海区人民医院神经内科,广东佛山528200 [3]广东省医学科学院/广东省人民医院放射科,广州510080

出　　处：《放射学实践》2022年第2期165-169,共5页Radiologic Practice

基　　金：佛山市卫生健康局医学科研基金(20210393)。

摘　　要：目的:探讨MRI大脑脚脚间角测量在诊断低颅压综合征中的临床价值。方法:搜集经临床诊断的43例低颅压综合征患者及性别、年龄相匹配的43例健康志愿者的临床和MRI资料。对比分析2组患者的主要MRI表现(包括有无硬脑膜增厚及/或强化、脑下垂、静脉窦扩张、硬膜下积液等)及大脑脚脚间角的差异。结果:低颅压组大脑脚脚间角为47.41°±2.30°,显著低于对照组(67.16°±1.40°),差异有统计学意义(t=-7.33,P<0.001)。ROC曲线显示以大脑脚脚间角<53.98°作为诊断低颅压综合征的阈值,敏感度为74.40%、特异度为97.7%。大脑脚脚间角与脑下垂征象呈显著负相关(P<0.001),与脑脊液压力呈正相关(P=0.005)。结论:基于MR图像定量测量大脑脚脚间角对低颅压综合征具有较高的诊断价值。Objective:To evaluate the value of the interpeduncular angle measured on brain MR images in the diagnosis of intracranial hypotension.Methods:Forty-three patients with intracranial hypotension and 43 normal control subjects with matched sex and ages were enrolled.The interpeduncular angles,defined as the angle formed by the anterior half of the cerebral peduncles obtained at the level of the mammillary bodies on axial T2-weighted images were measured and compared between the two groups.The main imaging characteristics included pachymeningeal enhancement(or thickening in cases with no gadolinium),subdural collections,venous engorgement,and brain stem slumping were analyzed and compared.Results:The average of interpeduncular angle in the patients with intracranial hypotension was significantly lower than that in control group(47.41°±2.30°vs.67.16°±1.40°;t=-7.33,P<0.001).The ROC curve analysis showed that when the threshold of interpeduncular angle was<53.98°for diagnosis of intracranial hypotension,the diagnostic sensitivity and specificity were 74.40%and 97.7%,respectively.There was significant correlation between the interpeduncular angle and the presence of brain stem slumping and CSF pressure(both P<0.001).Conclusion:The interpeduncular angle measured on MR images is useful in diagnosis in patients with intracranial hypotension,and it is practical on routine clinical MR imaging.

关 键 词：低颅压综合征 大脑脚脚间角 磁共振成像 定量分析 

分 类 号：R445.5[医药卫生—影像医学与核医学] R747.9[医药卫生—诊断学]