PC-MRI在Ⅰ型Chiari畸形伴咳嗽性头痛患者脑脊液动力学变化中的应用  

Application of phase-contrast magnetic resonance image in dynamic changes of cerebrospinal fluid fortypeⅠChiari malformation patients with cough headache

作　　者：刘晓虎 马栋斌 付兵[1] 高良超 LIU Xiao-hu;MA Dong-bin;FU Bing(Department of Radiology,the Fifth People's Hospital of Chengdu,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院放射科,成都611130 [2]成都市第五人民医院神经外科,成都611130

出　　处：《放射学实践》2024年第10期1306-1310,共5页Radiologic Practice

摘　　要：目的:探讨PC-MRI在Ⅰ型Chiari畸形伴咳嗽性头痛患者脑脊液动力学变化中的应用价值。方法:搜集2020年9月-2023年5月诊断为Ⅰ型Chiari畸形的患者39例,按是否伴有咳嗽性头痛症状,分为症状组23例,无症状组16例,另选取正常对照组18例,所有患者及正常对照人群均完成了PC-MRI的检查;以枕骨大孔水平脑桥腹侧平面为感兴趣区,分别获得症状组、无症状组患者及正常对照组人群脑脊液的头向峰值流速(V umax)、足向峰值流速(V dmax)及头向流动时间占比(T u)、足向流动时间占比(T d)。结果:分别测得症状组、无症状组与正常对照组头向峰值流速(V umax)为(6.38±0.89)cm/s、(5.92±1.32)cm/s、(4.86±0.90)cm/s,足向峰值流速(V dmax)为(5.87±1.01)cm/s、(5.71±1.32)cm/s、(4.62±0.83)cm/s,头向流动时间占比(T u)为(70.6±4.0)%、(58.7±3.2)%、(58.0±2.8)%,足向流动时间占比(T d)为(28.9±3.4)%、(41.2±3.3)%、(41.9±2.8)%;症状组与无症状组头向峰值流速(V umax)及足向峰值流速(V dmax)组间比较没有统计学差异(P>0.05),而症状组脑脊液头向流动时间占比(T u)较无症状组增大,足向流动时间占比(T d)较无症状组减小,且组间比较有统计学意义(P<0.01);无症状组与正常对照组间只存在脑脊液头向峰值流速(V umax)、足向峰值流速(V dmax)的统计学差异(P<0.01),而症状组与正常对照组间在脑脊液头向峰值流速(V umax)、足向峰值流速(V dmax)、头向流动时间占比(T u)及足向流动时间占比(T d)方面均存在统计学差异(P<0.01)。结论:PC-MRI对了解Ⅰ型Chiari畸形伴咳嗽性头痛患者脑脊液动力学变化具有重要价值,有助于了解咳嗽性头痛的病因。Objective:To investigate the application value of PC-MRI in the dynamic changes of cerebrospinal fluid of typeⅠChiari malformation patients with cough headache.Methods:A total of 39 patients with typeⅠChiari malformation diagnosed in our hospital from September 2020 to May 2023 were collected.According to the cough headache symptoms,23 cases were divided into symptomatic group,and 16 cases for asymptomatic group,another 18 cases of normal control group were selected.All the patients and normal controls received PC-MRI examination.The region of interest was the ventral pons at the level of the foramen magnum,The peak cephalad flow velocity(V umax),peak foot flow velocity(V dmax),the proportion of cephalad flow time(T u)and the proportion of foot flow time(T d)of cerebrospinal fluid(CSF)were obtained in symptomatic group,asymptomatic group and normal control group.Results:The peak cephalad flow velocity(V umax)in symptomatic group,asymptomatic group and normal control group were(6.38±0.89)cm/s,(5.92±1.32)cm/s,(4.86±0.90)cm/s,while the peak foot flow velocity(V dmax)were(5.87±1.01)cm/s,(5.71±1.32)cm/s,(4.62±0.83)cm/s,and the proportion of cephalad flow time(T u)were(70.6±4.0)%,(58.7±3.2)%,(58.0±2.8)%,the proportion of foot flow time(T d)were(28.9±3.4)%,(41.2±3.3)%,(41.9±2.8)%,respectively.There were no significant differences in the peak cephalad velocity(V umax)and peak foot velocity(V dmax)between the symptomatic group and the asymptomatic group(P>0.05),while the proportion of cephalad flow time(T u)increased and the proportion of foot flow time(T d)decreased in the symptomatic group,with the significant differences(P<0.01)compared to the asymptomatic group.There were only statistical differences of the peak cephalad flow velocity(V umax)and the peak foot flow velocity(V dmax)between asymptomatic group and normal control group(P<0.01),while the statistical differences in the peak cephalad flow velocity(V umax),the peak foot flow velocity(V dmax),the proportion of cephalad flow time(T u)and the prop

关 键 词：磁共振成像 CHIARI畸形 头痛症 原发性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R729[医药卫生—诊断学] R741.041[医药卫生—临床医学]