Borzage Matthew, Ponrartana Skorn, Tamrazi Benita, Gibbs Wende, Nelson Marvin D, McComb J Gordon, Blüml Stefan
Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Childs Nerv Syst. 2018 Sep;34(9):1677-1682. doi: 10.1007/s00381-018-3845-3. Epub 2018 Jun 6.
Abnormal cerebrospinal fluid (CSF) dynamics can produce a number of significant clinical problems to include hydrocephalus, loculated areas within the ventricles or subarachnoid spaces as well as impairment of normal CSF movement between the cranial and spinal compartments that can result in a cerebellar ectopia and hydrosyringomyelia. Thus, assessing the patency of fluid flow between adjacent CSF compartments non-invasively by magnetic resonance imaging (MRI) has definite clinical value. Our objective was to demonstrate that a novel tag-based CSF imaging methodology offers improved contrast when compared with a commercially available application.
In a prospective study, ten normal healthy adult subjects were examined on 3T magnets with time-spatial labeling inversion pulse (Time-SLIP) and a new tag-based flow technique-time static tagging and mono-contrast preservation (Time-STAMP). The image contrast was calculated for dark-untagged CSF and bright-flowing CSF. We tested the results with the D'Agostino and Pearson normality test and Friedman's test with Dunn's multiple comparison correction for significance. Separately 96 pediatric patients were evaluated using the Time-STAMP method.
In healthy adults, contrasts were consistently higher with Time-STAMP than Time-SLIP (p < 0.0001, in all ROI comparisons). The contrast between untagged CSF and flowing tagged CSF improved by 15 to 34%. In both healthy adults and pediatric patients, CSF flow between adjacent fluid compartments was demonstrated.
Time-STAMP provided images with higher contrast than Time-SLIP, without diminishing the ability to visualize qualitative CSF movement and between adjacent fluid compartments.
异常的脑脊液（CSF）动力学可引发一系列严重的临床问题，包括脑积水、脑室内或蛛网膜下腔内的分隔区域，以及颅腔和脊髓腔之间正常脑脊液流动的受损，这可能导致小脑异位和脊髓空洞症。因此，通过磁共振成像（MRI）非侵入性地评估相邻脑脊液腔之间的液体流动通畅性具有明确的临床价值。我们的目的是证明，与市售应用相比，一种新型的基于标记的脑脊液成像方法能提供更好的对比度。
在一项前瞻性研究中，对10名正常健康成年受试者使用3T磁体，采用时间空间标记反转脉冲（Time-SLIP）和一种新的基于标记的流动技术——时间静态标记和单对比度保留（Time-STAMP）进行检查。计算未标记的暗脑脊液和流动的亮脑脊液的图像对比度。我们使用D'Agostino和Pearson正态性检验以及Friedman检验，并采用Dunn多重比较校正来检验结果的显著性。另外，对96名儿科患者使用Time-STAMP方法进行评估。
在健康成年人中，Time-STAMP的对比度始终高于Time-SLIP（在所有感兴趣区域比较中，p < 0.0001）。未标记的脑脊液和流动的标记脑脊液之间的对比度提高了15%至34%。在健康成年人和儿科患者中，均显示了相邻液体腔之间的脑脊液流动。
Time-STAMP提供的图像对比度高于Time-SLIP，同时不降低可视化脑脊液定性运动以及相邻液体腔之间运动的能力。
