PC cine MRI在脑积水的诊断及治疗中的临床价值

发布时间：2018-03-29 10:14

本文选题：磁共振成像　切入点：相位对比　出处：《宁夏医科大学》2015年硕士论文

【摘要】：目的:应用磁共振相位对比电影成像(Phase-contrast cine Magnetic Resonance Imaging,PC cine MRI)分析正常志愿者、交通性脑积水、不同部位梗阻性脑积水脑导水管平面CSF流动曲线、流量、流速、绝对搏出量(Absolute Stroke Volume,ASV)及中脑导水管中段(壶腹部)面积,研究不同组别之间流动特性的差异,并探讨应用PC cine MRI在脑积水的诊疗评估的临床价值。方法:设立正常志愿者组5例;脑积水组:交通性脑积水脑积水组8例,梗阻性脑积水7例(中脑导水管狭窄4例、三室占位2例、四室占位1例)。应用philips I n t e r a Achieva 1.5T超导磁共振扫描仪,采用外周门控,MRI分别采集颅脑常规图像及CSF流量(或流速)分析图像。扫描数据输入后传到MR Extended Workspace R2.6.31工作站,用CSF-QF-Clear软件对导水管内CSF流动进行定性与定量分析。对比分析不同组别CSF流动曲线、流量、流速、绝对搏出量、中脑导水管中段(壶腹部)面积。结果:5例正常志愿者CSF流动曲线呈正弦波形;8例交通性脑积水组呈欠规则正弦波形;中脑导水管狭窄性与三室占位、四室占位性梗阻性脑积水曲线图分别呈4例欠规则锯齿状及3例欠规则正弦波形。正常志愿者与三室占位脑积水流量(或流速)无统计学意义(P0.05);余各组间比较均具有统计学义(P0.05)。正常志愿者中脑导水管面积与交通性脑积水、中脑导水管狭窄性梗阻性脑积水组间有统计学意义(P0.05)。交通性脑积水ASV分别于正常志愿者、中脑导水管狭窄性、三室占位性及四室占位性梗阻性脑积水组之间有统计学差异(P0.05)。结论:(1)正常志愿者CSF流动曲线呈正弦波形,交通性脑积水呈欠规则正弦波形,梗阻性脑积水呈欠规则锯齿状或欠规则正弦波形。(2)交通性脑积水通过ROI面积的流量(流速)最高,四脑室占位性梗阻性脑积水具第二,正常志愿者与三室占位性梗阻性脑积水居第三,中脑导水管狭窄性梗阻性脑积水最低。(3)交通性脑积水的ROI面积最大,中脑导水管狭窄性梗阻性脑积水ROI面积最小。(4)交通性通性脑积水ASV最大,脑室顺应性最差。
[Abstract]:Objective: to analyze the CSF flow curve, flow rate, flow rate and velocity of cerebral aqueduct in normal volunteers, traffic hydrocephalus and obstructive hydrocephalus by using phase contrast imaging of magnetic resonance phase contrast cine cine Magnetic Resonance imaging PC cine MRI. Absolute Stroke volume (ASV) and midbrain aqueduct (ampulla) were used to study the difference of flow characteristics among different groups, and to evaluate the clinical value of PC cine MRI in the diagnosis and treatment of hydrocephalus. In the hydrocephalus group, there were 8 cases of communicating hydrocephalus, 7 cases of obstructive hydrocephalus (4 cases of mesencephalic aqueduct stenosis, 2 cases of three-compartment space occupation and 1 case of four-ventricular occupying position). The superconducting magnetic resonance scanner (philips I n t e r a Achieva 1.5T) was used. Peripheral gated MRI was used to collect conventional brain images and CSF flow (or velocity) analysis images. The scanning data were inputted to Mr Extended Workspace R2.6.31 workstation. The qualitative and quantitative analysis of CSF flow in aqueduct was carried out by CSF-QF-Clear software. The flow curve, flow rate, flow velocity, absolute stroke volume of CSF in different groups were compared and analyzed. Results the CSF flow curve of 5 normal volunteers was sinusoidal and 8 cases of communicating hydrocephalus showed irregular sinusoidal shape, the mesencephalic aqueduct stenosis and three-ventricular space occupied, the area of midbrain aqueduct in middle segment (ampulla) of 5 normal volunteers was sinusoidal. The curve of four-compartment obstructive hydrocephalus was irregular serrated in 4 cases and irregular sine wave in 3 cases. There was no significant difference in flow (or velocity) between normal volunteers and three-compartment occupying hydrocephalus (P 0.05). The area of cerebral aqueduct and communicating hydrocephalus in normal volunteers. There was statistically significant difference between patients with obstructive hydrocephalus with stenosis of aqueduct in midbrain (P 0.05). ASV of communicating hydrocephalus was significantly higher than that of normal volunteers and stenosis of aqueduct of midbrain. There was significant difference between the three compartment occupying and four compartment obstructive hydrocephalus groups (P 0.05). Conclusion the CSF flow curve of normal volunteers is sinusoidal, and the traffic hydrocephalus is irregular sine wave. Obstructive hydrocephalus presented irregular zigzag or irregular sinusoidal shape. 2) the flow rate (velocity) of communicating hydrocephalus through ROI area was the highest, and the fourth ventricle occupied obstructive hydrocephalus was the second. The ROI area of communicating hydrocephalus was the largest in normal volunteers and three-ventricle occupied obstructive hydrocephalus, and the lowest in mesencephalic aqueduct stenosis obstructive hydrocephalus, and the lowest in mesencephalic aqueduct stenosis obstructive hydrocephalus. The area of ROI in obstructive hydrocephalus with aqueduct stenosis was the smallest. 4) the ASV of communicating hydrocephalus was the largest and the compliance of ventricle was the worst.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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