Departments of Brain & Cognitive Sciences, Physiology & Cell Biology, Faculty of Health Science, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Magn Reson Imaging. 2018 Apr;47(4):913-927. doi: 10.1002/jmri.25857. Epub 2017 Sep 27.
Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a clear cause.
To investigate dynamic imaging findings in IIH and their relation to mechanisms underlying intracranial pressure normalization.
Prospective.
Eighteen IIH patients and 30 healthy controls.
FIELD STRENGTH/SEQUENCE: T -weighted, venography, fluid attenuation inversion recovery, and apparent diffusion coefficients were acquired on 1.5T scanner.
The dural sinus was measured before and after lumbar puncture (LP). The degree of sinus occlusion was evaluated, based on 95% confidence intervals of controls. We studied a number of neuroimaging biomarkers associated with IIH (sinus occlusion; optic nerve; distribution of cerebrospinal fluid into the subarachnoid space, sulci and lateral ventricles (LVs); Meckel's caves; arachnoid granulation; pituitary and choroid plexus), before and after LP, using a set of specially developed quantification techniques.
Relationships among various biomarkers were investigated (Pearson correlation coefficient) and linked to long-term disease outcomes (logistic regression). The t-test and the Wilcoxon rank test were used to compare between controls and before and after LP data.
As a result of LP, the following were found to be in good accordance with the opening pressure: relative compression of cerebrospinal fluid (R = -0.857, P < 0.001) and brain volumes (R = -0.576, P = 0.012), LV expansion (R = 0.772, P < 0.001) and venous volume (R = 0.696, P = 0.001), enlargement of the pituitary (R = 0.640, P = 0.023), and shrinkage of subarachnoid space (R = -0.887, P < 0.001). The only parameter that had an impact on long-term prognosis was cross-sectional size of supplemental drainage veins after LP (sensitivity of 92%, specificity of 20%, and area under the curve of 0.845, P < 0.001).
We present an approach for quantitative characterization of the intracranial venous system and its implementation as a diagnostic assistance tool. We conclude that formation of supplementary drainage veins might serve as a long-lasting compensatory mechanism.
2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:913-927.
特发性颅内高压(IIH)的特征是颅内压升高而没有明确的病因。
研究 IIH 的动态影像学表现及其与颅内压正常化机制的关系。
前瞻性。
18 例 IIH 患者和 30 名健康对照者。
磁场强度/序列：在 1.5T 扫描仪上采集 T 加权、静脉造影、液体衰减反转恢复和表观扩散系数。
腰椎穿刺（LP）前后测量硬脑膜窦。基于对照组的 95%置信区间，评估窦腔闭塞程度。我们使用一组专门开发的定量技术，研究了与 IIH 相关的一些神经影像学生物标志物（窦腔闭塞；视神经；脑脊液分布到蛛网膜下腔、脑沟和侧脑室（LV）； Meckel 氏腔；蛛网膜颗粒；垂体和脉络丛），在 LP 前后进行研究。
用 Pearson 相关系数研究各种生物标志物之间的关系，并与长期疾病结局（logistic 回归）相关联。t 检验和 Wilcoxon 秩检验用于比较对照组和 LP 前后的数据。
LP 后，以下指标与颅内压呈良好相关性：脑脊液相对受压（R = -0.857，P < 0.001）和脑容积（R = -0.576，P = 0.012）、LV 扩张（R = 0.772，P < 0.001）和静脉容积（R = 0.696，P = 0.001）、垂体增大（R = 0.640，P = 0.023）和蛛网膜下腔缩小（R = -0.887，P < 0.001）。唯一对长期预后有影响的参数是 LP 后补充引流静脉的横截面积（灵敏度 92%，特异性 20%，曲线下面积 0.845，P < 0.001）。
我们提出了一种定量描述颅内静脉系统的方法，并将其作为一种诊断辅助工具。我们得出的结论是，形成补充引流静脉可能是一种持久的代偿机制。
2 技术功效：3 级 J. Magn. Reson. Imaging 2018;47:913-927.
