中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2011年
4期
335-338
,共4页
郑佳平%陈国强%肖庆%梁晖
鄭佳平%陳國彊%肖慶%樑暉
정가평%진국강%초경%량휘
神经内镜%脑积水%导水管成形术%磁共振相位电影对比法%脑脊液流动%动力学
神經內鏡%腦積水%導水管成形術%磁共振相位電影對比法%腦脊液流動%動力學
신경내경%뇌적수%도수관성형술%자공진상위전영대비법%뇌척액류동%동역학
Neuroendoscope%Hydrocephalus%Aqueductoplasty%Phase - contrast eine MRI%Cerebrospinal fluid flow%Dynamics
目的 探讨磁共振相位电影对比成像法在内镜下导水管成形术治疗导水管梗阻性脑积水的应用价值.方法 对23例诊断为导水管梗阻性脑积水的患者,术前常规采用磁共振相位电影对比法进一步确诊；手术采用电子软性神经内镜下导水管成形术,术中对导水管阻塞程度进行评估.术后1周及随访均采用磁共振相位电影对比法复查来测量导水管脑脊液流速流量以确定导水管是否开通.结果 23例术前磁共振相位电影对比法未见导水管脑脊液流动患者,术中见导水管完全闭塞或直径小于1 mm2；23例患者成形术均获成功,导水管扩张平均在4 mm左右,术后1周电影成像检查导水管平均流速为(4.74±1.77) cm/s,在随访期间,2例再次出现颅高压症状的患者,电影成像显示导水管未见脑脊液流动,二次内镜下探查见导水管重新闭塞.结论 磁共振相位电影对比法通过测量导水管内脑脊液流速流量来精确判断导水管开通情况,可以作为导水管梗阻性脑积水术前诊断及导水管成形术后疗效判断及随访的重要工具.
目的 探討磁共振相位電影對比成像法在內鏡下導水管成形術治療導水管梗阻性腦積水的應用價值.方法 對23例診斷為導水管梗阻性腦積水的患者,術前常規採用磁共振相位電影對比法進一步確診；手術採用電子軟性神經內鏡下導水管成形術,術中對導水管阻塞程度進行評估.術後1週及隨訪均採用磁共振相位電影對比法複查來測量導水管腦脊液流速流量以確定導水管是否開通.結果 23例術前磁共振相位電影對比法未見導水管腦脊液流動患者,術中見導水管完全閉塞或直徑小于1 mm2；23例患者成形術均穫成功,導水管擴張平均在4 mm左右,術後1週電影成像檢查導水管平均流速為(4.74±1.77) cm/s,在隨訪期間,2例再次齣現顱高壓癥狀的患者,電影成像顯示導水管未見腦脊液流動,二次內鏡下探查見導水管重新閉塞.結論 磁共振相位電影對比法通過測量導水管內腦脊液流速流量來精確判斷導水管開通情況,可以作為導水管梗阻性腦積水術前診斷及導水管成形術後療效判斷及隨訪的重要工具.
목적 탐토자공진상위전영대비성상법재내경하도수관성형술치료도수관경조성뇌적수적응용개치.방법 대23례진단위도수관경조성뇌적수적환자,술전상규채용자공진상위전영대비법진일보학진；수술채용전자연성신경내경하도수관성형술,술중대도수관조새정도진행평고.술후1주급수방균채용자공진상위전영대비법복사래측량도수관뇌척액류속류량이학정도수관시부개통.결과 23례술전자공진상위전영대비법미견도수관뇌척액류동환자,술중견도수관완전폐새혹직경소우1 mm2；23례환자성형술균획성공,도수관확장평균재4 mm좌우,술후1주전영성상검사도수관평균류속위(4.74±1.77) cm/s,재수방기간,2례재차출현로고압증상적환자,전영성상현시도수관미견뇌척액류동,이차내경하탐사견도수관중신폐새.결론 자공진상위전영대비법통과측량도수관내뇌척액류속류량래정학판단도수관개통정황,가이작위도수관경조성뇌적수술전진단급도수관성형술후료효판단급수방적중요공구.
Objective To evaluate the application of phase-contrast cine magnetic resonance imaging (MRI) in endoscopic aqueductoplasty for patients with obstructive hydrocephalus.Methods The clinical diagnosis of hydrocephalus due to aqueduct obstruction in 23 patients was confirmed by phase -contrast cine MRI examination.The patients were treated with endoscopic aqueductoplasty.MRI was repeated during follow- up period.The cerebrospinal fluid (CSF) flow velocity in aqueduct was measured to determine whether the aqueduct was obstructed.Results The Results of phase - contrast cine MRI examinations indicated that there was no CSF flow in aqueduct in any patient.Aqueductoplasty was successfully performed in all patients.after one week,the Results of phase - contrast cine MRI examinations showed an average CSF flow velocity of ( 4.74 ± 1.77 ) cm/s.During follow - up period,intracranial hypertension recurred in two patients in whom CSF flow was not seen inside the aqueduct by phase - contrast cine MRI scan and the aqueduct re - occlusion was revealed by endoscopic exploration.Conclusions By measuring CSF flow velocity,phase - contrast cine MRI could accurately identify whether the aqueduct is obstructed.It should play an important role in the diagnosis of obstructive hydrocephalus and evaluation of the effectiveness of aqueductoplasty,and it could be used for follow -up evaluation as well.
