Bapuraj J Rajiv, Londy Frank J, Delavari Nader, Maher Cormac O, Garton Hugh J L, Martin Bryn A, Muraszko Karin M, Ibrahim El-Sayed H, Quint Douglas J
Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
J Magn Reson Imaging. 2016 Aug;44(2):463-70. doi: 10.1002/jmri.25160. Epub 2016 Jan 20.
To assess the effects of cerebrospinal fluid (CSF) bidirectional motion in Chiari malformation type I (CMI), we monitored CSF velocity amplitudes on phase contrast MRI (PC-MRI) in patients before and after surgery; and in healthy volunteers.
10 pediatric volunteers and 10 CMI patients participated in this study. CMI patients underwent PC-MRI scans before and approximately 14 months following surgery. Two parameters-amplitude of mean velocity (AMV) and amplitude of peak velocity (APV) of CSF-were derived from the data. Measurements were made at the mid-portion of the cerebral aqueduct, and anterior and posterior compartments of the spinal canal at the craniovertebral junction (CVJ).
AMV and APV within the cerebral aqueduct were greater in preoperative assessments of the CMI patients compared to normal volunteers. Statistical significance was noted when comparing aqueductal AMV between the preoperative values and normal controls (P = 0.03), and before and after surgery in the CMI patients (P = 0.02). Lower values of AMV (P = 0.02) were noted in the anterior CVJ compartment in the patients before and after surgery when compared to the normal volunteers. There were no significant correlations (P = 0.06) noted for the APV at the CVJ between the normal control and patients, before or after surgery.
In pediatric CMI patients, AMV for CSF within the cerebral aqueduct and anterior CVJ subarachnoid space are significantly elevated preoperatively and normalize following surgery. Given the biphasic CSF motion, measuring amplitude accounts for cranial and caudal flow. It may offer an alternative parameter to assess postsurgical outcome. J. Magn. Reson. Imaging 2016;44:463-470.
为评估脑脊液（CSF）双向运动在Ⅰ型Chiari畸形（CMI）中的作用，我们在手术前后对患者以及健康志愿者进行了相位对比磁共振成像（PC-MRI）检查，监测脑脊液速度幅值。
10名儿科志愿者和10名CMI患者参与了本研究。CMI患者在手术前及术后约14个月接受了PC-MRI扫描。从数据中得出两个参数——脑脊液平均速度幅值（AMV）和峰值速度幅值（APV）。测量在中脑导水管中部以及颅颈交界（CVJ）处椎管的前后间隙进行。
与正常志愿者相比，CMI患者术前评估中脑导水管内的AMV和APV更高。在比较术前值与正常对照组之间以及CMI患者手术前后的导水管AMV时，具有统计学意义（P = 0.03和P = 0.02）。与正常志愿者相比，手术前后患者CVJ前间隙的AMV值较低（P = 0.02）。正常对照组与患者手术前后CVJ处的APV之间未发现显著相关性（P = 0.06）。
在儿科CMI患者中，术前中脑导水管和CVJ前蛛网膜下腔内脑脊液的AMV显著升高，术后恢复正常。鉴于脑脊液的双相运动，测量幅值可反映头向和尾向流动。它可能为评估术后结果提供一个替代参数。《磁共振成像杂志》2016年；44:463 - 470。
