Missios Symeon, Quebada Patricia B, Forero Jorge A, Durham Susan R, Pekala Joseph S, Eskey Clifford J, Duhaime Ann-Christine
Division of Neurosurgery and, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
J Neurosurg Pediatr. 2008 Dec;2(6):438-44. doi: 10.3171/PED.2008.2.12.438.
In 2002, "quick-brain" (QB) MR imaging (ultrafast spin echo T2-weighted imaging) was introduced as an alternative technique to CT scanning for assessing children with hydrocephalus. The authors have observed high patient and physician satisfaction with this technique at their institution, which has led to an increasing frequency of its use for nonhydrocephalic indications. The goal in this study was to characterize, quantitate, and assess the use of QB MR imaging for these additional indications.
Between February 2003 and December 2007, 1146 consecutive QB MR imaging studies were performed, and the findings were entered prospectively into a radiology database. All available clinical records were retrospectively reviewed to assign > or = 1 of the following indications to each study: hydrocephalus, macrocephaly, Chiari malformation, intracranial cyst, screening prior to lumbar puncture, screening for congenital anomalies, trauma, and other. Changes in the distribution of indications over time and clinical experience for each indication were reviewed.
The total number of QB imaging studies performed increased each year. The proportion of studies performed for nonhydrocephalic indications also increased (from 23 to 50%). The most common indication was screening for macrocephaly, and all other indications were nearly evenly distributed. Quick-brain MR imaging was used extensively for the initial evaluation and follow-up in patients with little need for additional studies. Its false-negative rate, however, remains unknown.
The role of QB MR imaging for nonhydrocephalic indications is expanding, and it appears promising for a number of screening and surveillance paradigms. "Quick-brain plus" protocols for specific indications may add sensitivity and are under development.
2002年，“快速脑”（QB）磁共振成像（超快自旋回波T2加权成像）作为一种替代CT扫描的技术被引入，用于评估脑积水患儿。作者在其机构观察到患者和医生对该技术的满意度较高，这导致其用于非脑积水适应症的频率不断增加。本研究的目的是描述、量化并评估QB磁共振成像在这些额外适应症中的应用。
在2003年2月至2007年12月期间，连续进行了1146例QB磁共振成像研究，并将结果前瞻性地录入放射学数据库。对所有可用的临床记录进行回顾性审查，为每项研究指定以下适应症中的≥1项：脑积水、巨头畸形、Chiari畸形、颅内囊肿、腰椎穿刺前筛查、先天性异常筛查、创伤及其他。回顾了适应症分布随时间的变化以及每种适应症的临床经验。
每年进行的QB成像研究总数均有所增加。用于非脑积水适应症的研究比例也有所增加（从23%增至50%）。最常见的适应症是巨头畸形筛查，其他所有适应症分布几乎均匀。QB磁共振成像广泛用于几乎无需额外检查的患者的初始评估和随访。然而，其假阴性率尚不清楚。
QB磁共振成像在非脑积水适应症中的作用正在扩大，在一些筛查和监测模式中似乎很有前景。针对特定适应症的“快速脑增强”方案可能会提高敏感性，目前正在研发中。
