基于影像学无创性评价高颅压准确性的对比分析  

Comparative Analysis on the Accuracy of Noninvasive Evaluation of High Intracranial Pressure Based on Imaging

作　　者：刘鹏涛 于京隔 刘兆会[2] LIU Pengtao;YU Jingge;LIU Zhaohui(Department of Radiology,Dezhou Lingcheng District People's Hospital,Dezhou,Shandong Province 253500,P.R.China)

机构地区：[1]山东省德州市陵城区人民医院影像科,253500 [2]首都医科大学附属北京同仁医院放射科,100730

出　　处：《临床放射学杂志》2024年第7期1078-1082,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:82071882);北京市自然科学基金项目(编号:7222029)。

摘　　要：目的对比无创性评价颅内压的不同影像学方法,探讨其优势与不足。方法纳入完成腰椎脑脊液穿刺的颅内压增高患者15例。应用CT和MRI检查基于横窦狭窄指数(ITSS)、颅脑形态学特征定性评价颅内压增高与否,基于视神经周围蛛网膜下腔宽度定性和定量评估颅内压增高与否。结果基于ITSS方法和颅脑形态学特征定性诊断颅内压增高的准确率分别为100%和93.3%。基于视神经周围蛛网膜下腔宽度定性诊断颅内压增高的准确率为86.7%,定量计算颅内压值为(210.83±28.04)mmH_(2)O,与腰椎穿刺测量颅内压值(222.33±31.67 mmH_(2)O)之间差异无显著统计学意义(t=1.053,P=0.301),但与腰椎穿刺测量颅内压值相比,基于视神经蛛网膜下腔宽度测量的颅内压值平均降低(11.5±3.63)mmH_(2)O。结论ITSS是诊断颅内压增高准确性最高的无创性影像学方法,可定性诊断颅内压有无增高,然后再应用视神经周围蛛网膜下腔宽度测量颅内压,在此数值基础上增加(11.5±3.63)mmH_(2)O作为定量评价颅内压的参考值。Objective To Compare the different imaging methods for non-invasive evaluation of intracranial pressure,exploring strengths and weaknesses.Methods Fifteen patients with high intracranial pressure who completed lumbar cerebrospinal fluid puncture were enrolled.Application of CT and MRI for qualitative evaluation of increased intracranial pressure based on the Index of transverse sinus stenosis(ITSS)and brain morphological features.Qualitative and quantitative evaluation of increased intracranial pressure based on the orbital subarachnoid space width(OSASW)around the optic nerve.Results The accuracy of the qualitative diagnosis of increased intracranial pressure based on the ITSS and brain morphological features was 100% and 93.3%,respectively.The accuracy of the qualitative diagnosis of increased intracranial pressure based on OSASW was 86.7%.There was no significant difference between the quantitatively calculated intracranial pressure value of(210.83±28.04)mmH_(2)O based on OSASW and the intracranial pressure value measured by lumbar puncture(222.33±31.67)mmH_(2)O.However,compared with lumbar puncture,intracranial pressure values based on OSASW measurements were reduced by a mean of(11.5±3.63)mmH_(2)O.Conclusion ITSS is the most accurate noninvasive imaging method to diagnose increased intracranial pressure qualitatively.Then applying OSASW to measure intracranial pressure,and add(11.5±3.63)mmH_(2)O to this value as a reference value for quantitative evaluation of intracranial pressure.

关 键 词：颅内压 横窦狭窄指数 视神经周围蛛网膜下腔宽度 形态学特征 

分 类 号：R816.1[医药卫生—放射医学] R742[医药卫生—临床医学] R445.2