Chan L-L, Ng K-M, Fook-Chong S, Lo Y-L, Tan E-K
Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Republic of Singapore.
Neurology. 2009 Sep 29;73(13):1054-7. doi: 10.1212/WNL.0b013e3181b9c8ce.
We hypothesize that a smaller posterior fossa (PF) CSF space may be a risk factor for hemifacial spasm (HFS).
We conducted a case-control 3-dimensional magnetic resonance (MR) volumetric study in patients with HFS and determined the clinical predictive factors of PF CSF volume.
Patients with clinically diagnosed HFS and controls matched for age, sex, race, and hypertension underwent MRI/magnetic resonance angiography examination. The PF CSF space was segmented and quantified on a heavily T2-weighted high-resolution 3-dimensional MR volume slab, centered over the porus acusticus.
Eighty-two study subjects (41 patients and 41 controls) were included. The mean PF CSF volume in patients with HFS and controls was 17,303.0 +/- 3,900.0 vs 19,216.0 +/- 3,912.0 mm(3). The mean volume in patients with HFS was 11.4% smaller than in controls (p = 0.015). Analysis of differences between individually matched pairs and controls also revealed that PF CSF for controls was larger than that for patients with HFS (p = 0.007). A multivariate linear regression analysis revealed that a small PF CSF volume was associated with HFS (p = 0.01). Decreasing age (p = 0.001) and female gender (p < 0.0005), but not hypertension (p = 0.892), were also found to be predictors of a low PF CSF volume.
Our results showed that the posterior fossa (PF) CSF volume was lower in patients with HFS compared with matched controls. HFS, female gender, and younger age were associated with smaller PF CSF volume. These observations could explain the strong female preponderance in both clinic- and population-based epidemiologic studies.
我们推测后颅窝（PF）脑脊液空间较小可能是面肌痉挛（HFS）的一个危险因素。
我们对HFS患者进行了一项病例对照三维磁共振（MR）容积研究，并确定了PF脑脊液体积的临床预测因素。
对临床诊断为HFS的患者以及年龄、性别、种族和高血压相匹配的对照组进行MRI/磁共振血管造影检查。在以听神经孔为中心的重T2加权高分辨率三维MR容积层面上，对PF脑脊液空间进行分割和量化。
纳入82名研究对象（41例患者和41名对照）。HFS患者和对照组的平均PF脑脊液体积分别为17303.0±3900.0与19216.0±3912.0 mm³。HFS患者的平均体积比对照组小11.4%（p = 0.015）。对个体匹配对与对照组之间差异的分析还显示，对照组的PF脑脊液体积大于HFS患者（p = 0.007）。多因素线性回归分析显示，PF脑脊液体积小与HFS相关（p = 0.01）。年龄降低（p = 0.001）和女性（p < 0.0005），而非高血压（p = 0.892），也被发现是PF脑脊液体积低的预测因素。
我们的结果表明，与匹配的对照组相比，HFS患者的后颅窝（PF）脑脊液体积较低。HFS、女性和较年轻的年龄与较小的PF脑脊液体积相关。这些观察结果可以解释在临床和基于人群的流行病学研究中女性占优势的现象。
