磁振造影顱內壓量測的重現性與切面內腦脊髓液流速的影響

MR imaging-based intracranial pressure estimation: reproducibility and contributions of in-plane CSF flow.

吳宜螢(Yi-Ying Wu)

指導教授 ： 鍾孝文

國立臺灣大學/電機資訊學院/生醫電子與資訊學研究所/碩士(2012年)

https://doi.org/10.6342/NTU.2012.00312

摘要

目前在臨床上用於量測人體顱內壓技術是一種相當高侵入性的技術。利用從體外放入壓力偵測探頭至中樞神經系統(側腦室或腰椎)來觀測人體的顱內壓變化量。但是，在進行此高侵入性方法的診斷或治療時，往往病人會伴隨著感染或是引發其他併發症。這樣高風險的侵入式技術並非每位受檢者都有辦法承受，因此，我們想要發展出一套由相位對比磁共振影像為基礎出發的非侵入性顱內壓檢測技術。
先前的研究已經提出利用動態相位對比磁共振影像來估測顱內壓以及其相關參數。在這個研究中，我們想要重複這個數年前就已被廣泛接受的方法，並且更進一步地去探討這個方法在正常受試者身上的可重複性以及精確性，除此之外，還原先前研究的一些簡化與假設，讓此相位對比磁共振影像用於非侵入性地量測人體顱內壓的技術更健全完善以便提供更清楚的臨床意義。

關鍵字

相位對比磁共振影像 ； 非侵入性顱內壓量測 ； 顱內彈性係數 ； 腦脊髓液 ； 流體力學

並列摘要

Currently the ICP measurement method performed in clinical practice is a highly invasive technique. An external pressure detector has to be placed in the central nervous system such as lateral ventricle or lumbar spine for monitoring the pressure changes. However, the continuous ICP monitoring is usually accompanied by risks including possible infections. In addition, in the surgical procedure may impose potential morbidity for the patients. These considerations drive investigators to develop noninvasive techniques for ICP estimation.
Previous studies have proposed noninvasive cine phase-contrast MRI method to estimate the ICP and its related indices, ICC and ICE, based on blood / CSF volumetric flow rates and CSF pressure gradient. In this study, we attempted to repeat this accepted measurement method to assess its precision level on healthy subjects, and at the same time verify the validity of some simplified assumptions
practically in order to get more comprehensive estimation as well as provide clearer clinical significance.

並列關鍵字

MR-intracranial pressure ； intracranial compliance ； intracranial elastance ； cerebrospinal fluid dynamic ； phase contrast magnetic resonance imaging

參考文獻

2. Morgan, R.R.a.R.J., Intracranial pressure monitoring. Current Anaesthesia & Critical Care, 2003. 14: p. 229-235.

4. Dunn, L.T., Raised intracranial pressure. J Neurol Neurosurg Psychiatry, 2002. 73 Suppl 1: p. i23-7.

5. Marmarou, A., K. Shulman, and J. LaMorgese, Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system. J Neurosurg, 1975. 43(5): p. 523-34.

6. Raksin, P.B., et al., Noninvasive intracranial compliance and pressure based on dynamic magnetic resonance imaging of blood flow and cerebrospinal fluid flow: review of principles, implementation, and other noninvasive approaches. Neurosurg Focus, 2003. 14(4): p. e4.

7. Alperin, N.J., et al., MR-Intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study. Radiology, 2000. 217(3): p. 877-85.