Fuh J-L, Wang S-J, Lai T-H, Hseu S-S
The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Cephalalgia. 2008 Apr;28(4):318-22. doi: 10.1111/j.1468-2982.2007.01498.x. Epub 2008 Feb 18.
The timing and clinical relevance of diffuse pachymeningeal enhancement (DPE) in the magnetic resonance imaging (MRI) examination of patients with spontaneous intracranial hypotension (SIH) remain undetermined. We reviewed 53 consecutive SIH patients (30 F/23 M, mean age of onset 41.7 +/- 11.3 years) in a tertiary hospital. Thirteen (24.5%) patients did not have DPE on their initial cranial MRIs. They had significantly shorter latency between the time of MRI examinations and the time of headache onset compared with those with DPE (6.5 +/- 4.4 vs. 20.4 +/- 16.3 days, t-test, P < 0.001). Eight of these 13 patients received a follow-up MRI (mean duration 30.3 +/- 16.6 days, range 6-59 days) and six of them revealed DPE. Among patients with DPE, the enhancement disappeared as early as 25 days after headache onset. The outcome did not differ between patients with and without DPE. The presence of DPE was associated with the timing of the MRI examination.
在自发性颅内低压（SIH）患者的磁共振成像（MRI）检查中，弥漫性硬脑膜强化（DPE）的时间及临床相关性仍未明确。我们回顾了一家三级医院连续收治的53例SIH患者（30例女性/23例男性，平均发病年龄41.7±11.3岁）。13例（24.5%）患者初次头颅MRI检查时未出现DPE。与出现DPE的患者相比，他们在MRI检查时间与头痛发作时间之间的潜伏期明显更短（6.5±4.4天对20.4±16.3天，t检验，P<0.001）。这13例患者中的8例接受了随访MRI检查（平均时长30.3±16.6天，范围6 - 59天），其中6例显示出现了DPE。在出现DPE的患者中，强化最早在头痛发作后25天消失。出现DPE和未出现DPE的患者预后无差异。DPE的出现与MRI检查的时间有关。
