Normal and Abnormal Cerebrospinal Fluid Dynamics Evaluated by Optimized Cine Phase-contrast MR Imaging

正常與不正常大腦脊髓液運動使用高解析二維相位對比磁振造影技術與評估

江龍輝(Lung-Hui Giiang) ； 陳震宇(Cheng-Yu Chen) ； 陳明彥(Ming-Yen Chen) ； 黃滕毅(Teng-Yi Huang) ； 鍾孝文(Hsiao-Wen Chung)

《中華放射線醫學雜誌》 25卷5期 (2000/10) Pp. 191-195

摘要

To evaluate the normal and abnormal cerebrospinal fluid (CSF) hydrodynamics by quantitatively measuring the peak velocity of CSF in the aqueduct using two- dimensional cine phase-contrast magnetic resonance (MR) imaging.
A prospective CSF flow study was performed with the use of an optimized two-dimensional cine phase-contrast MR technique. Ten normal age-matched volunteers (mean age 58.5 years) and 20 patients with abnormal CSF hydrodynamics were enrolled. The patient groups include 16 normal pressure hydrocephalus (NPH) cases (mean age 69.2 years) and four with communicating hydrocphalus (CH) (mean age 38.5 years). All images were acquired on both sagittal and axial planes using a bipolar gradient pulse sequence on a 1.5-tesla scanner (Siemens Vsion+, Erlangen, Germany).
The mean maximum CSF flow velocities (Vmax) at the aqueduct were 4.93 ± 0.28 cm/s (mean ± SD) for the control group, and 6.22 ± 0.67 and 7.24 ± 1.08 cm/s for the NPH and CH groups, respectively.
The NPH group could be further divided into hyper-and hypodynamic groups when compared with the normal agematched subjects. Vmax of the control group was significantly higher than that of the hypodynamic-NPH group (1.92 ± 1.11 cm/s, p ＜ 0.001) and lower than that of the CH group (p ＜ 0.007) and of the hyperdynamic-NPH group (10.52 ± 0.23 cm/s, p ＜ 0.001)
With optimized parametric setting, two-dimensional cine phase-contrast MR imaging appears to be practical for routine evaluation of patients for routine evaluation of patients with abnormal CSF flow dynamics. The peak velocity of the CSF flow was significantly higher in the hyperdynamic-NPH group but lower in the hypodynamic-NPH group as compared with the control group. Our results confirm that, in MPH patients, a pre-surgical MR imaging evaluation of CSF potentially can be very helpful in distinguishing the low-CSF-dynamic from high-CSF-dynamic groups before any CSF diversion procedure is contemplated.

關鍵字

磁振造影 ； 大腦脊髓液 ； 相位對比影像 ； 常壓性水腦

並列摘要

To evaluate the normal and abnormal cerebrospinal fluid (CSF) hydrodynamics by quantitatively measuring the peak velocity of CSF in the aqueduct using two- dimensional cine phase-contrast magnetic resonance (MR) imaging.
A prospective CSF flow study was performed with the use of an optimized two-dimensional cine phase-contrast MR technique. Ten normal age-matched volunteers (mean age 58.5 years) and 20 patients with abnormal CSF hydrodynamics were enrolled. The patient groups include 16 normal pressure hydrocephalus (NPH) cases (mean age 69.2 years) and four with communicating hydrocphalus (CH) (mean age 38.5 years). All images were acquired on both sagittal and axial planes using a bipolar gradient pulse sequence on a 1.5-tesla scanner (Siemens Vsion+, Erlangen, Germany).
The mean maximum CSF flow velocities (Vmax) at the aqueduct were 4.93 ± 0.28 cm/s (mean ± SD) for the control group, and 6.22 ± 0.67 and 7.24 ± 1.08 cm/s for the NPH and CH groups, respectively.
The NPH group could be further divided into hyper-and hypodynamic groups when compared with the normal agematched subjects. Vmax of the control group was significantly higher than that of the hypodynamic-NPH group (1.92 ± 1.11 cm/s, p ＜ 0.001) and lower than that of the CH group (p ＜ 0.007) and of the hyperdynamic-NPH group (10.52 ± 0.23 cm/s, p ＜ 0.001)
With optimized parametric setting, two-dimensional cine phase-contrast MR imaging appears to be practical for routine evaluation of patients for routine evaluation of patients with abnormal CSF flow dynamics. The peak velocity of the CSF flow was significantly higher in the hyperdynamic-NPH group but lower in the hypodynamic-NPH group as compared with the control group. Our results confirm that, in MPH patients, a pre-surgical MR imaging evaluation of CSF potentially can be very helpful in distinguishing the low-CSF-dynamic from high-CSF-dynamic groups before any CSF diversion procedure is contemplated.

並列關鍵字

Magnetic resonance imaging (MRI) ； cerebrospinal fluid ； Cine magnetic resonance imaging ； Normal pressure hydrocephalus (NPH)