Dinçer Alp, Yildiz Erdem, Kohan Saeed, Memet Özek M
Department of Radiology, School of Medicine, Acibadem University, Inonu Cad. Okur Sok. No: 21, Kozyatagi, İstanbul, Turkey.
Childs Nerv Syst. 2011 Jan;27(1):127-35. doi: 10.1007/s00381-010-1219-6. Epub 2010 Jul 15.
PURPOSE: The aim of the study is to evaluate the efficiency of turbo spin-echo (TSE), three-dimensional constructive interference in the steady state (3D CISS) and cine phase contrast (Cine PC) sequences in determining flow through the endoscopic third ventriculostomy (ETV) fenestration, and to determine the effect of various TSE sequence parameters. MATERIALS AND METHODS: The study was approved by our institutional review board and informed consent from all patients was obtained. Two groups of patients were included: group I (24 patients with good clinical outcome after ETV) and group II (22 patients with hydrocephalus evaluated preoperatively). The imaging protocol for both groups was identical. TSE T2 with various sequence parameters and imaging planes, and 3D CISS, followed by cine PC were obtained. Flow void was graded as four-point scales. The sensitivity, specificity, accuracy, positive and negative predictive values of sequences were calculated. RESULTS: Bidirectional flow through the fenestration was detected in all group I patients by cine PC. Stroke volumes through the fenestration in group I ranged 10-160.8 ml/min. There was no correlation between the presence of reversed flow and flow void grading. Also, there was no correlation between the stroke volumes and flow void grading. The sensitivity of 3D CISS was low, and 2 mm sagittal TSE T2, nearly equal to cine PC, provided best result. CONCLUSION: Cine PC and TSE T2 both have high confidence in the assessment of the flow through the fenestration. But, sequence parameters significantly affect the efficiency of TSE T2.
目的:本研究旨在评估快速自旋回波(TSE)、三维稳态构成干扰序列(3D CISS)和电影相位对比(Cine PC)序列在确定经内镜第三脑室造瘘术(ETV)造瘘口血流情况方面的效率,并确定各种TSE序列参数的影响。 材料与方法:本研究经机构审查委员会批准,并获得所有患者的知情同意。纳入两组患者:第一组(24例ETV术后临床效果良好的患者)和第二组(22例术前评估为脑积水的患者)。两组的成像方案相同。获取具有不同序列参数和成像平面的TSE T2序列、3D CISS序列,随后进行电影相位对比序列成像。血流空洞按四分制进行分级。计算各序列的敏感性、特异性、准确性、阳性和阴性预测值。 结果:电影相位对比序列在所有第一组患者中均检测到经造瘘口的双向血流。第一组患者经造瘘口的每搏输出量范围为10 - 160.8 ml/min。反向血流的存在与血流空洞分级之间无相关性。此外,每搏输出量与血流空洞分级之间也无相关性。3D CISS序列的敏感性较低,2mm矢状位TSE T2序列的效果最佳,几乎与电影相位对比序列相当。 结论:电影相位对比序列和TSE T2序列在评估造瘘口血流方面均具有较高的可信度。但是,序列参数显著影响TSE T2序列的效率。
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