Takahashi Yuko, Hori Masaaki, Shimoji Kazuaki, Miyajima Masakazu, Akiyama Osamu, Arai Hajime, Aoki Shigeki
Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
Acta Radiol Open. 2017 Aug 31;6(9):2058460117728535. doi: 10.1177/2058460117728535. eCollection 2017 Sep.
In patients with craniosynostosis, intracranial pressure (ICP) has been reported to increase even in the absence of overt symptoms. The early and non-invasive detection of intracranial hypertension is important for reducing the risk of abnormal brain development in pediatric patients.
To assess whether the apparent diffusion coefficient (ADC) of white matter during the cardiac cycle (ΔADC) would change after surgery to relieve ICP in children with craniosynostosis.
This prospective study included ten patients diagnosed with craniosynostosis and four normal controls. All ten patients underwent magnetic resonance (MR) examinations before and after surgical treatment. Single-shot diffusion MR imaging (MRI) triggered by an electrocardiogram was performed, with regions of interest (ROIs) placed on frontal white matter and basal ganglia.
In all ten patients, ΔADC values after surgery were higher than those before surgery. This difference was statistically significant (Wilcoxon signed-rank test, = 0.005).
The change in ΔADC in the frontal white matter before and after surgery in patients with craniosynostosis indicates that it might reflect the change in ICP. Measurements of ΔADC could be a promising tool for non-invasive monitoring of ICP.
据报道，在颅缝早闭患者中，即使没有明显症状，颅内压（ICP）也会升高。早期无创检测颅内高压对于降低小儿患者脑发育异常的风险很重要。
评估颅缝早闭患儿在进行缓解ICP的手术后，心动周期中白质的表观扩散系数（ADC）（ΔADC）是否会发生变化。
这项前瞻性研究纳入了10例诊断为颅缝早闭的患者和4名正常对照者。所有10例患者在手术治疗前后均接受了磁共振（MR）检查。采用心电图触发的单次激发扩散磁共振成像（MRI），并将感兴趣区（ROI）置于额叶白质和基底节区。
在所有10例患者中，术后的ΔADC值均高于术前。这种差异具有统计学意义（Wilcoxon符号秩检验，P = 0.005）。
颅缝早闭患者手术前后额叶白质中ΔADC的变化表明，它可能反映了ICP的变化。ΔADC的测量可能是一种有前景的无创监测ICP的工具。
