Matsuzawa H, Hida K, Houkin K, Yoshinobu I, Abe H, Akino M, Saito H
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
No To Shinkei. 1992 Jan;44(1):24-9.
Some reports show the qualitative analysis of cerebrospinal fluid (CSF) pulsation in the subarachnoid space and the syrinx using cine magnetic resonance imaging (MRI). However, few reports studied the quantitative analysis of CSF pulsation. We report here the results of quantitative analysis of CSF pulsation using the cine MRI with pre-saturation pulse. Using flow phantom, we calibrated the correlation between the true velocity and calculated velocity acquired from the movement of pre-saturated low signal. Three cases of syringomyelia with Chiari malformation, two cases of traumatic syringomyelia, and three normal volunteers were examined using this technique, and we could obtain time-velocity curves of CSF in both subarachnoid spaces and syrinx. Although obvious pulsation of CSF was observed in the syrinx of all Chiari malformations, no pulsation of CSF was observed in the syrinx of traumatic syringomyelia. CSF in the syrinx moves upward in the early systolic cardiac cycle, downward in the systolic cycle, and upward again in the diastolic cycle. Patterns of CSF pulsation in syrinx were similar to those in the subarachnoid space, but "phase" of these pulsations differed from case to case. These results suggest the close relationship between CSF pulsation in the syrinx and CSF obstruction at the cranio-vertebral junction. Dissociation of the "phase" of CSF pulsation in the syrinx and subarachnoid space may be significant in the analysis of the pathogenesis of syringomyelia.
一些报告展示了利用电影磁共振成像（MRI）对蛛网膜下腔和脊髓空洞症中的脑脊液（CSF）搏动进行的定性分析。然而，很少有报告研究脑脊液搏动的定量分析。我们在此报告使用带有预饱和脉冲的电影MRI对脑脊液搏动进行定量分析的结果。使用流动模型，我们校准了真实速度与从预饱和低信号移动获取的计算速度之间的相关性。使用该技术对3例伴有Chiari畸形的脊髓空洞症、2例创伤性脊髓空洞症患者以及3名正常志愿者进行了检查，我们能够获得蛛网膜下腔和脊髓空洞症中脑脊液的时间 - 速度曲线。尽管在所有Chiari畸形的脊髓空洞症中均观察到脑脊液有明显搏动，但在创伤性脊髓空洞症的脊髓空洞症中未观察到脑脊液搏动。脊髓空洞症中的脑脊液在心脏收缩早期向上移动，在收缩期向下移动，在舒张期再次向上移动。脊髓空洞症中脑脊液搏动的模式与蛛网膜下腔中的相似，但这些搏动的“相位”因病例而异。这些结果表明脊髓空洞症中的脑脊液搏动与颅颈交界处的脑脊液梗阻之间存在密切关系。脊髓空洞症和蛛网膜下腔中脑脊液搏动“相位”的解离在脊髓空洞症发病机制分析中可能具有重要意义。
