相位对比 MRI 测量通过脑导水管的净脑脊液流动会受到呼吸的干扰。
Phase contrast MRI measurements of net cerebrospinal fluid flow through the cerebral aqueduct are confounded by respiration.
机构信息
Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands.
Spinoza Center for Neuroimaging, Amsterdam, Netherlands.
出版信息
J Magn Reson Imaging. 2019 Feb;49(2):433-444. doi: 10.1002/jmri.26181. Epub 2018 May 9.
BACKGROUND
Net cerebrospinal fluid (CSF) flow through the cerebral aqueduct may serve as a marker of CSF production in the lateral ventricles, and changes that occur with aging and in disease.
PURPOSE
To investigate the confounding influence of the respiratory cycle on net CSF flow and stroke volume measurements.
STUDY TYPE
Cross-sectional study.
SUBJECTS
Twelve young, healthy subjects (seven male, age range 19-39 years, average age 28.3 years).
FIELD STRENGTH/SEQUENCE: Phase contrast MRI (PC-MRI) measurements were performed at 7T, with and without respiratory gating on expiration and on inspiration. All measurements were repeated.
ASSESSMENT
Net CSF flow and stroke volume in the aqueduct, over the cardiac cycle, was determined.
STATISTICAL TESTS
Repeatability was determined using the intraclass correlation coefficient (ICC) and linear regression analysis between the repeated measurements. Repeated measures analysis of variance (ANOVA) was performed to compare the measurements during inspiration/expiration/no gating. Linear regression analysis was performed between the net CSF flow difference (inspiration minus expiration) and stroke volume.
RESULTS
Net CSF flow (average ± standard deviation) was 0.64 ± 0.32 mL/min (caudal) during expiration, 0.12 ± 0.49 mL/min (cranial) during inspiration, and 0.31 ± 0.18 mL/min (caudal) without respiratory gating. Respiratory gating did not affect stroke volume measurements (41 ± 18, 42 ± 19, 42 ± 19 μL/cycle for expiration, no respiratory gating and inspiration, respectively). Repeatability was best during inspiration (ICC = 0.88/0.56/-0.31 for gating on inspiration/expiration/no gating). A positive association was found between average stroke volume and net flow difference between inspiration and expiration (R = 0.678/0.605, P = 0.015/0.037 for the first/second repeated measurement).
DATA CONCLUSION
Measured net CSF flow is confounded by respiration effects. Therefore, net CSF flow measurements with PC-MRI cannot in isolation be directly linked to CSF production.
LEVEL OF EVIDENCE
1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:433-444.
背景
脑池脑脊液（CSF）通过脑水管的净流量可作为侧脑室 CSF 生成的标志物，并可随年龄增长和疾病而变化。
目的
研究呼吸周期对 CSF 净流量和每搏量测量的混杂影响。
研究类型
横断面研究。
受试者
12 名年轻健康的受试者（7 名男性，年龄 19-39 岁，平均年龄 28.3 岁）。
磁场强度/序列：在 7T 上进行相位对比 MRI（PC-MRI）测量，呼气和吸气时分别带有和不带有呼吸门控。所有测量均重复进行。
评估
在心动周期内，确定脑水管中的 CSF 净流量和每搏量。
统计学检验
使用组内相关系数（ICC）和重复测量之间的线性回归分析来确定重复性。使用重复测量方差分析（ANOVA）比较吸气/呼气/无门控时的测量值。进行线性回归分析，以确定净 CSF 流量差（吸气减呼气）与每搏量之间的关系。
结果
呼气时 CSF 净流量（平均值±标准差）为 0.64±0.32mL/min（尾侧），吸气时为 0.12±0.49mL/min（头侧），无呼吸门控时为 0.31±0.18mL/min（尾侧）。呼吸门控对每搏量测量没有影响（分别为呼气、无呼吸门控和吸气时的 41±18、42±19、42±19μL/周期）。吸气时重复性最好（门控吸气/呼气/无门控时的 ICC 分别为 0.88/0.56/-0.31）。发现平均每搏量与吸气与呼气之间的净流量差之间存在正相关（第一次/第二次重复测量时的 R 值分别为 0.678/0.605，P 值分别为 0.015/0.037）。
数据结论
测量的 CSF 净流量受到呼吸效应的影响。因此，PC-MRI 测量的 CSF 净流量不能孤立地直接与 CSF 生成相关联。
证据水平
1 技术功效：第 2 阶段 J. Magn. Reson. Imaging 2019；49：433-444。
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