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題名 | 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 |
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作者 | 江龍輝; 陳震宇; 陳明彥; 黃滕毅; 鍾孝文; Giiang, Lung-hui; Chen, Cheng-yu; Chen, Ming-yen; Huang, Teng-yi; Chung, Hsiao-wen; |
期刊 | 中華放射線醫學雜誌 |
出版日期 | 20001000 |
卷期 | 25:5 2000.10[民89.10] |
頁次 | 頁191-195 |
分類號 | 415.838 |
語文 | eng |
關鍵詞 | 磁振造影; 大腦脊髓液; 相位對比影像; 常壓性水腦; Magnetic resonance imaging; MRI; Cerebrospinal fluid; Cine magnetic resonance imaging; Normal pressure hydrocephalus; NPH; |
中文摘要 | 本研究之目的在使用高解析度二維相位對比磁振造影定量正常與不正常大腦脊髓液運動,以提供臨床醫師治療不正常大腦脊髓液運動病人做參考。 我們使用1.5 tesla scanner 分別取得矢狀及軸位切面的高解析度二維相位對比磁振造影影像,針對30位成年人,包括10 位正常受試者(平均約58.5 歲)和20位不正常大腦脊髓液運動病人做參考。其中16 位高常壓性水腦(平均約62.2 歲),4 位交通性水腦(平均約38.5 歲),進行大腦脊髓液流速的定量研究。研究方法乃使用高解析影像在大腦導水管的截面積獲得18 至22 個含相角變化的相素,運用大腦導水管內大腦脊髓液的相角變化,測量大腦脊髓液的最大搏出速度。 四組受試者中,以高常壓性水腦患者的最大流速(10.52 ± 0.23 cm/s, p < 0.001)比其它三組高,而交通性水腦患者次之(7.24 ± 1.08cm/s, p < 0.007),其次為正常受試者(4.93 ± 0.28 cm/s; mean ± SD),最低的是低常壓性水腦的病患(1.92 ± 1.11, p < 0.001)。 使用高解析度二維相位對比磁振造影技術定量正常與不正常大腦脊髓液運動,可獲得比較穩定且信賴度高的測量值。高常壓性水腦患者有最高的大腦脊髓液搏出速度,遠高於正常受試者及低常壓性水腦的病患的大腦脊髓液搏出速度,顯示大腦對腦室內脊髓液的推力比正常人高,所以,從本報告吾人建議使用高解析度二維相位對比磁振造影影像,來鑑別高流速及低流速常壓性水腦患者,並且對於高常壓性水腦患者術前評估很有幫助,進一步使用脊髓液引流術治療效果可能比較明顯。 |
英文摘要 | 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 hydrocephalus (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 Vision+, 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 age-matched 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 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 NPH patients, a pre-surgical MR imaging evaluation of CSF potentially can be very helpful in distinguishing the low-CSFdynamic from high-CSF-dynamic groups before any CSF diversion procedure is contemplated. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。