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題名 | 利用二維相位對比磁振造影技術正常小孩顱內腦脊髓液流量評估=Quantification of Cerebrospinal Fluid in Normal Children with Two-dimensional Cine Phase-Contrast MR Imaging |
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作者 | 江龍輝; 陳震宇; 陳明彥; 黃騰毅; 羅中平; 張慶灃; 王昭穎; 何宛萍; 黃國書; | 書刊名 | 中華放射線技術學雜誌 |
卷期 | 32:2 2008.12[民97.12] |
頁次 | 頁131-140 |
分類號 | 414.93 |
關鍵詞 | 高解析相位對比磁振造影; 雙極梯度; 峰值流量; 淨搏動量; Phase-contrast MRI; Bipolar gradient; Peak velocity; Stroke volume; |
語文 | 中文(Chinese) |
中文摘要 | 本研究利用高解析相位對比磁振造影影像技術(Phase-Contrast MR Imaging with hightemporal and spatial resolution),提供一個很有用且非侵入性的方法,來評估小兒顱內腦脊髓液(cerebrospinal fluid, CSF)流量的正常值並提供小兒神經疾病診斷的參考依據。此結果將幫助我們瞭解正常小孩的腦脊髓液產量並區別一些不正常腦脊髓液流體動力所衍生的疾病,例如常壓性水腦(normal pressure hydrocephalus, NPH)、腦萎縮合併腦室擴大等疾病。都可藉由腦脊髓液流量量測來瞭解在某種疾病病程下,腦脊髓液是如何自動調節並協助臨床評估診治。高解析相位對比磁振造影技術,是利用流體波序的雙極梯度(bipolar gradient)與相位對比波序,使流動的氫核的相角與速度成正比的原理,進而分析正常小孩腦內,在大腦導水管(aqueduct)處腦脊髓液的流量。本研究以峰值流量(peak flow)及淨搏動量(netstroke volume)做評估指標,共有6位受試案例(5位男性,1位女性,年齡從1歲5個月至2歲6個月之間),每位受試者均爲臨床上疑似癲癇(seizure)的病人,但經醫學影像學檢查及最終臨床診斷無腦部異常者爲研究對象。結果顯示,正常小孩腦內在腦導水管處腦脊髓液的峰值流量從93.15±34.62 ul/s(微升/秒)到382.43±21.22 ul/s不等,平均爲235.68±89.64 ul/s,而淨搏動量平均爲18.66±12.94 ul/hb(微升/每次心臟搏動)並與2004年Radiology一篇研究結果做比較,該篇研究定量出正常成人(15位男性,4位女性,年齡從21-39歲之間)之腦脊髓液的流量,健康成年人峰值流量平均爲131±81 ul/s與淨搏動量平均爲4.53±2.40 ul/hb,兩研究結果相較之下,小孩之腦脊髓液流量平均高於正常成人許多,研究結果可進一步用於解釋,常見於小孩之腦部軸位fast spin echo T2WI影像,即使此波序已加上流體補償效應(flow compensation effect),小孩大腦導水管處之流動無訊號區(flow void)仍比大人來的明顯與常見。高解析相位對比磁振造影技術是一種臨床上非常方便、精準、非侵入性而有用的技術,此技術在未來,有希望協助瞭解人類腦脊髓液分泌機轉,並對於一些腦部疾病的病理生理學與腦脊髓液的關係,提供了一項最佳可信賴的研究工具。 |
英文摘要 | The study was performed using cine phase-contrast magnetic resonance imaging (MRI) with high temporal and spatial resolution, which provides a useful and non-invasive method to quantify the cerebrospinal fluid (CSF) in normal flow children. The results can be served as the references for the diagnosis of pediatric neurological disorders. It also help us to understand the CSF production rates in normal children and some diseases related to abnormal CSF flow dynamics, such as normal pressure hydrocephalus, brain atrophy with secondary dilatation of the ventricles. By measuring the CSF flow, it's helpful for clinicians to understand the autoregulation mechanisms in certain diseases, and to diagnose and treat those patients. High-resolution phase-contrast MRI technique is a flow sequence by means of bipolar gradient and phase-contrast sequence. The theory is based on the velocities of the flowing protons being proportional to their flip angles, thereafter evaluating the velocity and stroke volume of the CSF in the cerebral aqueducts in the normal children. We use peak velocity and net stroke volume as the parameters in this study. Six patients (5 male, 1 female, age ranging from 1 year and 5 months to 2 years and 6 months) were enrolled. All of the subjects were initially under clinical suspicion of seizure disorders and were finally proved to be normal in both imaging and clinical aspects. The study reveals that the peak CSF flow velocity in the cerebral aqueduct in the normal children were 235.68±89.64 ul/s, and the mean net stroke volume is 18.66±12.94 ul/heart beat. Comparing the results in 19 normal adults (15 male, 4 female, age ranging from 21 to 39 years) in one of the articles in Radiology in 2004 with the mean peak velocity of 131±81ul/s and the net stroke volume of 4.53±2.40, the two parameters in normal children are significantly higher than that in the normal adults. The results explain the more common and apparent flow void phenomenon in the cerebral aqueducts on fast spin-echo T2-weighted images (even with flow compensation effect) in children as compared to the adults. Cine phase-contrast MRI with high temporal and spatial resolution is a very convenient, accurate and non-invasive technique. It's promising to help understand the human CSF secretion mechanism, and provides a reliable method to investigate the pathophysiology of the brain disease related to abnormal CSF flow dynamics. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。