鞘内注射Gd-DTPA增强MR脊髓及脑池造影的临床应用价值  

Study of clinical value of intrathecal Gd-DTPA-enhanced MR myelography and cisternography

作　　者：邓刚[1] 曾庆玉[1] 霍建伟[1] 吴戈[1] 郭玉仁 

机构地区：[1]北京煤炭总医院影像科 [2]山东省青岛市胶州中心医院放疗科

出　　处：《中国CT和MRI杂志》2004年第1期12-15,共4页Chinese Journal of CT and MRI

基　　金：国家煤炭部科学技术发展项目(项目编号:96-589-1)

摘　　要：目的 评估鞘内注射Gd-DTPA增强MR脊髓和脑池造影。 方法 对6例临床需要判断脑脊液流动性的患者进行鞘内注射Gd-DTPA增强MR脊髓和脑池造影检查。其中男性4例,女性2例;年龄20～60岁(平均38岁)。术前征得患者同意,经腰椎穿刺,蛛网膜腔内注入Gd-DTPA 0.5(n=4)～1.0(n=2)ml。采用西门子1.0T超导磁共振机,分别于脊髓造影前后进行脊柱及病变区横断及矢状T1W和T2W MR扫描并保持扫描参数不变,5例患者辅以病变区脂肪抑制T1W扫描。结果 6例患者MR平扫均不能显示脑脊液流动情况。鞘内注射Gd-DTPA后所有患者无任何不适,未发现异常神经系统体征。MR脊髓和脑池造影扫描显示,4例脊柱外伤病变,3例椎管完全闭塞,另1例部分闭塞;1例椎管内肿瘤术后囊腔与蛛网膜腔不交通;1例脑脊液鼻漏患者显示颅底的脑内外窦道。结论 鞘内注射小剂量Gd-DTPA安全可靠,脊髓和脑池造影增强MR扫描可显示常规MR扫描所不能显示的脑脊液动力学变化,对某些临床特定病例有重要意义。Objective To study the clinical value of Gd-DTPA-enhancedmyelography and cisternography. Methods 6 patients who were necessaryto know their conditions of CSF flow were studied.They consisted of 4male and 2 female with an age range of 20～60 years and an average of38.An injection of Gd-DTPA was given through lumbar puncture.Thedosage of Gd-DTPA was 0.5ml in 4 cases and 1.0ml in 2.Before and afterthe injection,MRI was performed with a 1.0 T MR unit(Magneton Impact,Siemens)with sequence of SE sagittal and axial T1W and T2W scanning.In 5 cases additional fat-aspirated T1W was performed over the diseasedregion. Results No CSF pathway was observed with conventional MRIin all the cases.No case showed gross behavioral and neurological changes.Gd-enhanced MRI showed severe traumatic spinal stenosis in 4 cases.3 ofthem suffered from complete obstruction of CSF and the fourth one frompartial obstruction.One case showed no communication between thesubarachnoid space and a cyst resulting from the resection of an intraspinaltumor.One case showed an abnormal CSF pathway in skull base. ConclusionIntrathecal of small dose of Gd DTPA is safe.Myelography and cisternographyscanned with Gd-DTPA-enhanced MRI can reveal the abnormalities whichcann’t be shown with conventional MRI.It can be concluded that Gd-DTPA-enhanced MRI plays an important role in the diagnosis of certaindiseases.

关 键 词：鞘内注射 GD-DTPA MR 脊髓造影 脑池造影 增强扫描 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]