Algin Oktay, Ucar Murat, Ozmen Evrim, Borcek Alp Ozgun, Ozisik Pinar, Ocakoglu Gokhan, Tali E Turgut
1Department of Radiology, Ataturk Training and Research Hospital;
2Bilkent University, National MR Research Center (UMRAM), Bilkent, Ankara;
J Neurosurg. 2015 Jun;122(6):1347-55. doi: 10.3171/2014.10.JNS14298. Epub 2015 Apr 10.
The goal of this study was to determine the value of the 3D sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) technique in the evaluation of endoscopic third ventriculostomy (ETV) patency.
Twenty-six patients with ETV were examined using 3-T MRI units. Sagittal-plane 3D-SPACE with variant flip-angle mode, 3D T1-weighted (T1W), and 3D heavily T2-weighted (T2W) images were obtained with isotropic voxel sizes. Also, sagittal-axial plane phase-contrast cine (PC)-MR images were obtained. The following findings were evaluated: diameters of stoma and third ventricle, flow-void sign on 3D-SPACE and PC-MR images, integrity of the third ventricle on heavily T2W images, and quantitative PC-MRI parameters of the stoma. Obtained sequences were evaluated singly, in combination with one another, and all together.
The mean area, flow, and velocity values measured at the level of stoma in patients with patent stoma were significantly higher than those measured in patients with closed stoma (p < 0.05). There was significant correlation among PC-MRI, 3D-SPACE, and 3D heavily T2W techniques regarding assessment of ETV patency (p < 0.001). The 3D-SPACE technique provided the lowest rate of ambiguous results.
The 3D-SPACE technique seems to be the most efficient one for determination of ETV patency. The authors suggest the use of 3D-SPACE as a stand-alone first-line sequence in addition to routine brain MRI protocols in assessing patients with ETV, thereby decreasing scan time and reserving the use of a combination of additional sequences such as PC-MRI and 3D heavily T2W images in suspicious or complex cases.
本研究的目的是确定采用不同翻转角演变的应用优化对比剂三维采样完美成像（3D-SPACE）技术在评估内镜下第三脑室造瘘术（ETV）通畅性中的价值。
使用3T磁共振成像（MRI）设备对26例接受ETV的患者进行检查。采用各向同性体素大小获取矢状面可变翻转角模式的3D-SPACE、三维T1加权（T1W）和三维重T2加权（T2W）图像。此外，还获取了矢状-轴面相位对比电影（PC）-MR图像。评估以下结果：造瘘口和第三脑室的直径、3D-SPACE和PC-MR图像上的流空信号、重T2W图像上第三脑室的完整性以及造瘘口的定量PC-MRI参数。对获取的序列进行单独评估、相互结合评估以及综合评估。
造瘘口通畅患者在造瘘口水平测得的平均面积、流量和速度值显著高于造瘘口闭合患者（p<0.05）。在评估ETV通畅性方面，PC-MRI、3D-SPACE和三维重T2W技术之间存在显著相关性（p<0.001）。3D-SPACE技术产生的模糊结果率最低。
3D-SPACE技术似乎是确定ETV通畅性最有效的技术。作者建议在评估ETV患者时，除了常规脑MRI协议外，将3D-SPACE作为独立的一线序列使用，从而减少扫描时间，并在可疑或复杂病例中保留使用PC-MRI和三维重T2W图像等附加序列组合。
