DTI在脑脊液引流对特发性颅内高压视神经的应用  

Application of DTI in cerebrospinal fluid drainage for idiopathic intracranial hypertension optic nerve

作　　者：刘博 樊红光[2] 祁佩红 史大鹏[2] LIU Bo;FAN Hong-guang;QI Pei-hong;SHI Da-peng(Department of Magnetic Resonance,Henan Province Hospital of Traditional Chinese Medicine,the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450002,China;Medical Imaging Center,Henan Provincial Peoples Hospital,Zhengzhou 450003,China;Department of Medical Imaging,the Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou Peoples Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省中医院,河南中医药大学第二附属医院磁共振室,郑州1450002 [2]河南省人民医院影像中心,郑州450003 [3]河南中医药大学第五临床医学院,郑州人民医院医学影像科,郑州450003

出　　处：《医药论坛杂志》2024年第6期573-577,共5页Journal of Medical Forum

基　　金：国家中医临床研究基地科研专项课题(2019JDZX086)。

摘　　要：目的 分析扩散张量成像(diffusion tensor imaging, DTI)在脑脊液引流对特发性颅内高压视神经的影像表现,并进行量化分析其功能应用。方法 选取2018年9月至2023年9月经河南省中医院检查证实的特发性颅内高压患者9例为研究对象,对9例特发性颅内高压进行视神经磁共振(magnetic resonance scanning, MRI)扫描和弥散张量成像分析,并评估了头痛的临床表现及其伴随症状,然后通过腰椎穿刺恢复正常颅内压,并在24 h内重新评估视神经参数,对二者进行对比分析。结果 脑脊液引流特发性颅内高压前后,对双眼视神经进行分析,视神经直径变化不明显,对比不存在统计学意义(P>0.05);直径变化不明显,差异无统计学意义(P>0.05);穿刺后视神经FA值为(0.547±0.036)×10^(3)mm^(2)/s、MD值为(1.017±0.073)×10^(3)mm^(2)/s,均较术前升高,差异均存在统计学意义(P<0.001);头痛及其他症状几乎都消失。结论 颅内压升高导致视神经微结构受压迫,引起细微病理改变,在颅内压恢复正常的数小时内,视神经受压的显微结构和临床症状得到显著改善,为预后评估及深入研究提供新的方法。Objective This study is to analyze the imaging manifestations of diffusion tensor imaging(DTI) in cerebrospinal fluid drainage on the optic nerve in idiopathic intracranial hypertension, and to quantitatively analyze its functional application.Methods Nine patients with idiopathic intracranial hypertension confirmed by examination in Henan Provincial Hospital of Traditional Chinese Medicine from September 2018 to September 2023 were studied.Optical nerve magnetic resonance imaging(MRI)scanning and diffusion tensor imaging were performed on 9 cases of idiopathic intracranial hypertension, and the clinical manifestations and accompanying symptoms of headache were evaluated. Normal intracranial pressure was then restored through lumbar puncture, and optic nerve parameters were reevaluated within 24 hours for comparative analysis.Results Before and after cerebrospinal fluid drainage idiopathic intracranial hypertension, the optic nerve diameter of both eyes was not significantly changed(P>0.05). There was no significant difference in diameter(P>0.05). After puncture, the FA value of optic nerve was(0.547±0.036) ×10^(3)mm^(2)/s, and the MD value was(1.017±0.073) ×10^(3)mm^(2)/s, both of which were higher than those before surgery, and the differences were statistically significant(P<0.001). Headaches and other symptoms almost disappeared.Conclusion Elevated intracranial pressure leads to compression of the optic nerve microstructure, causing subtle pathological changes. Within a few hours of intracranial pressure returning to normal, the microstructure and clinical symptoms of optic nerve compression are significantly improved, providing a new method for prognosis evaluation and in-depth research.

关 键 词：特发性颅内高压 MRI DTI 视神经 视神经鞘 腰椎穿刺 

分 类 号：R815[医药卫生—放射医学]