56例特发性正常压力脑积水患者的临床和MRI特征分析  

Clinical and MRI Characteristics of 56 Patients with Idiopathic Normal Pressure Hydrocephalus

作　　者：吴倩 何文杰 张协军[3] 夏军[2] WU Qian;HE Wenjie;ZHANG Xiejun;XIA Jun(Guangzhou Medical University,Guanghzou 511436,China;Department of Radiology,Shenzhen Second People's Hospital,Shenzhen 518035,China;Department of Neurosurgery,Shenzhen Second People's Hospital,Shenzhen 518035,China)

机构地区：[1]广州医科大学研究生院,广州511436 [2]深圳大学第一附属医院/深圳市第二人民医院医学影像科,广东深圳518035 [3]深圳大学第一附属医院/深圳市第二人民医院神经外科,广东深圳518035

出　　处：《CT理论与应用研究（中英文）》2024年第2期167-174,共8页Computerized Tomography Theory and Applications

基　　金：国家自然科学基金(机器学习构建特发性正常压力脑积水分流术预后模型:基于大脑结构与连接的磁共振研究(82171913))。

摘　　要：目的:对行手术确诊的特发性正常压力脑积水患者的临床和MRI表现进行分析和总结,研究其临床、MRI特征以提高对该疾病的认识。方法:回顾性分析56例行分流术确诊的特发性正常压力脑积水(iNPH)患者临床和术前MR(包括3DT1WI、T2WI、T2 FLAIR)资料,对iNPH常见MR影像征象进行评估和描述。结果:56例iNPH患者中,步态障碍、认知障碍及尿失禁的发生率分别为91.1%、60.7%及42.9%,经典三联征为23.2%;常见合并症依次为高血压(51.8%)、糖尿病(28.6%)及帕金森病(PD)(12.5%)。对56例iNPH患者MR图像进行分析,82.1%患者胼胝体角呈锐角,39.3%患者蛛网膜下腔不成比例扩大征象(DESH)阳性,DESH评分平均得分(5.24±1.27)。结论:iNPH确诊患者最常合并高血压、糖尿病和PD,经典三联征较少,典型的MR征象阳性率不高,阴性患者的诊断和预后预测仍然存在挑战,应结合其他临床检查明确诊断和治疗。Objective:To analyze and summarize the clinical and MRI manifestations of patients with idiopathic normal pressure hydrocephalus(iNPH)diagnosed via surgery in order to improve the understanding of this disease.Methods:We performed a retrospective analysis of the clinical and preoperative MR(including 3DT1WI,T2WI,and T2 FLAIR)data of 56 patients with iNPH diagnosed via shunt surgery at our hospital to evaluate and describe MR linear parameters and common radiological features.Results:Among the 56 patients with iNPH,91.1%,60.7%,and 42.9%showed gait disturbance,cognitive impairment,and urinary disturbance,respectively;the classical triad accounted for 23.2%.The most common comorbidities were hypertension(51.8%),diabetes(28.6%),and PD(12.5%).In the analysis of the 56 patients’MR images,82.1%had acute callosal angle and 39.3%,positive disproportionately enlarged subarachnoid space(DESH)signs,with a mean DESH score of(5.24±1.27).Conclusion:Patients with confirmed iNPH most often also have hypertension,diabetes mellitus,and PD.The classical triad is less frequent,and the positive rate of typical MR signs is not high.Thus,the accurate diagnosis and prognosis prediction of negative patients remains challenging and should be combined with other clinical examinations to clarify the diagnosis and treatment.

关 键 词：磁共振成像 特发性正常压力性脑积水 临床特征 

分 类 号：R445[医药卫生—影像医学与核医学]