Li Lusheng, Zhang Yuting, Li Yingliang, Zhai Xuan, Zhou Yudong, Liang Ping
Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Department of Neurosurgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
Clin Neurol Neurosurg. 2013 Apr;115(4):411-8. doi: 10.1016/j.clineuro.2012.06.021. Epub 2012 Jul 11.
The optimal management for middle fossa arachnoid cysts (MFAC) remains controversial, but cystocistern fenestration is effective. MFACs are divided into non-communicating arachnoid cysts (NCIAC) and communicating arachnoid cysts (CIAC). This retrospective observational study evaluated the role of phase-contrast cine magnetic resonance imaging (PC-MRI) in the diagnosis and postoperative evaluation of MFACs and assessed surgical outcomes.
Twenty-eight children with MFAC that were diagnosed by conventional neuroradiology were enrolled. PC-MRI was performed preoperatively. The clinical manifestations, cyst volumes and PC-MRI data were analyzed, and the flow of cerebrospinal fluid (CSF) at the fistula was qualitatively evaluated.
No communication with the adjacent subarachnoid space was found on preoperative PC-MRI in 20 patients, and they were diagnosed with NCIAC. A statistically significant decrease in cyst volume was observed in all 20 patients postoperatively. Symptoms resolved or improved in the 14 patients who were symptomatic preoperatively, and a positive CSF flow was found in all 20 patients postoperatively. PC-MRI diagnosed eight patients with CIAC, and the cyst sizes did not increase during follow-up.
Cystocistern fenestration is an effective treatment for children with lateral fissure IAC. PC-MRI can be used to determine the IAC type and to evaluate the effectiveness of cystocistern fenestration.
中颅窝蛛网膜囊肿（MFAC）的最佳治疗方案仍存在争议，但囊肿 - 脑池造瘘术是有效的。MFAC分为非交通性蛛网膜囊肿（NCIAC）和交通性蛛网膜囊肿（CIAC）。本回顾性观察研究评估了相位对比电影磁共振成像（PC - MRI）在MFAC诊断及术后评估中的作用，并评估了手术效果。
纳入28例经传统神经放射学诊断为MFAC的儿童。术前进行PC - MRI检查。分析临床表现、囊肿体积及PC - MRI数据，并定性评估瘘口处脑脊液（CSF）的流动情况。
20例患者术前PC - MRI显示囊肿与相邻蛛网膜下腔无交通，诊断为NCIAC。所有20例患者术后囊肿体积均有统计学意义的减小。术前有症状的14例患者症状缓解或改善，所有20例患者术后均发现CSF呈阳性流动。PC - MRI诊断出8例CIAC患者，随访期间囊肿大小未增加。
囊肿 - 脑池造瘘术是治疗外侧裂IAC患儿的有效方法。PC - MRI可用于确定IAC类型并评估囊肿 - 脑池造瘘术的效果。
