Akay R, Kamisli O, Kahraman A, Oner S, Tecellioglu M
Department of Neurology, and Department of Radiology, Turgut Ozal Medical Center, Inonu University, School of Medicine, Malatya, Turkey.
Eur Rev Med Pharmacol Sci. 2015 Sep;19(18):3475-9.
We aimed to evaluate dynamic cerebrospinal fluid (CSF) flow in idiopathic intracranial hypertension (IIH) patients with new MRI technology phase contrast cine (PCC) MRI.
Nineteen patients diagnosed with idiopathic intracranial hypertension and 11 healthy volunteers were included in this study. Nine of the IIH cases had been previously diagnosed and had been on drug treatment and 10 cases were diagnosed with IIH recently and had not been put on drug treatment yet. All CSF flow datas were evaluated by phase contrast-MRI using a 1,5 T MRI. The CSF flow was calculated in the equidistant MRI sequence which was taken through a cardiac cycle.
Mean aqueduct area in the IIH group was 3.04 ± 1.14 mm², mean peak rate was 3.29 ± 1.77 cm/sec, mean average rate was 0.35 ± 0.33 cm/sec and mean flow was 0.67 ± 0.95 ml/min. In the control group mean aqueduct area was 2.87 ± 1.01 mm², mean peak rate was 4.20 ± 1.40 cm/sec, mean average rate was 0.37 ± 0.18 cm/sec and mean flow was 0.64 ± 0.40 ml/min. A statistically significant difference was found for the PCC MRI parameter of mean rate value (p: 0.007) between the control group and IIH patients. A statistically insignificant (p: 0.058) but marked difference was found for mean flow value.
To our knowledge this study is the first CSF flow study in the idiopathic intracranial hypertension patients. We found a difference between the IIH groups and controls in mean rate and flow parameters. It was interesting that the mean rate and flow values of the untreated group that were higher than the controls. CSF flow analysis may be a marker to follow up IIH patients.
我们旨在使用新的磁共振成像（MRI）技术——相位对比电影（PCC）MRI，评估特发性颅内高压（IIH）患者的动态脑脊液（CSF）流动情况。
本研究纳入了19例诊断为特发性颅内高压的患者和11名健康志愿者。19例IIH患者中，9例先前已被诊断并接受药物治疗，10例最近被诊断为IIH且尚未接受药物治疗。所有脑脊液流动数据均使用1.5T MRI通过相位对比MRI进行评估。脑脊液流动情况是在一个心动周期内获取的等距MRI序列中计算得出的。
IIH组中脑导水管平均面积为3.04±1.14mm²，平均峰值流速为3.29±1.77cm/秒，平均平均流速为0.35±0.33cm/秒，平均流量为0.67±0.95ml/分钟。对照组中脑导水管平均面积为2.87±1.01mm²，平均峰值流速为4.20±1.40cm/秒，平均平均流速为0.37±0.1８cm/秒，平均流量为0.64±0.40ml/分钟。对照组与IIH患者之间，平均流速值的PCC MRI参数存在统计学显著差异（p：0.007）。平均流量值存在统计学上不显著（p：0.058）但明显的差异。
据我们所知，本研究是首次对特发性颅内高压患者进行的脑脊液流动研究。我们发现IIH组与对照组在平均流速和流量参数方面存在差异。有趣的是，未治疗组的平均流速和流量值高于对照组。脑脊液流动分析可能是随访IIH患者的一个指标。
