Puy Vincent, Zmudka-Attier Jadwiga, Capel Cyrille, Bouzerar Roger, Serot Jean-Marie, Bourgeois Anne-Marie, Ausseil Jérome, Balédent Olivier
Biochemistry Unit, CBH, Amiens University Medical CenterAmiens, France; INSERM U1088, Research GroupAmiens, France.
BioFlowImage Research Group, Jules Verne University of PicardyAmiens, France; Geriatric Unit, General HospitalSaint Quentin, France.
Front Aging Neurosci. 2016 Jun 29;8:154. doi: 10.3389/fnagi.2016.00154. eCollection 2016.
The equilibrium between the ventricular and lumbar cerebrospinal fluid (CSF) compartments may be disturbed (in terms of flow and biochemistry) in patients with chronic hydrocephalus (CH). Using flow magnetic resonance imaging (MRI) and CSF assays, we sought to determine whether changes in CSF were associated with biochemical alterations. Nine elderly patients with CH underwent phase-contrast MRI. An index of CSF dynamics (Idyn) was defined as the product of the lumbar and ventricular CSF flows. During surgery, samples of CSF were collected from the lumbar and ventricular compartments and assayed for chloride, glucose and total protein. The lumbar/ventricular (L/V) ratio was calculated for each analyte. The ratio between measured and expected levels (Ibioch) was calculated for each analyte and compared with Idyn. Idyn varied from 0 to 100.10(3)μl(2).s(2). In contrast to the L/V ratios for chloride and glucose, the L/V ratio for total protein varied markedly from one patient to another (mean ± standard deviation (SD): 2.63 ± 1.24). The Ibioch for total protein was strongly correlated with the corresponding Idyn (Spearman's R: 0.98; p < 5 × 10(-5)).We observed correlated alterations in CSF flow and biochemical parameters in patients with CH. Our findings also highlight the value of dynamic flow analysis in the interpretation of data on CSF biochemistry.
在慢性脑积水（CH）患者中，脑室与腰段脑脊液（CSF）腔室之间的平衡（在流量和生物化学方面）可能会受到干扰。我们使用流动磁共振成像（MRI）和脑脊液分析，试图确定脑脊液的变化是否与生化改变有关。9例老年CH患者接受了相位对比MRI检查。脑脊液动力学指数（Idyn）定义为腰段和脑室脑脊液流量的乘积。在手术过程中，从腰段和脑室腔室采集脑脊液样本，检测氯化物、葡萄糖和总蛋白。计算每种分析物的腰段/脑室（L/V）比值。计算每种分析物的测量值与预期值之比（Ibioch），并与Idyn进行比较。Idyn范围为0至100.10(3)μl(2).s(2)。与氯化物和葡萄糖的L/V比值不同，总蛋白的L/V比值在不同患者之间差异显著（平均值±标准差（SD）：2.63±1.24）。总蛋白的Ibioch与相应的Idyn密切相关（Spearman氏R：0.98；p<5×10(-5)）。我们观察到CH患者脑脊液流量和生化参数存在相关改变。我们的研究结果还强调了动态流量分析在解释脑脊液生物化学数据方面的价值。
