新生儿、婴儿、儿童及青少年腰骶部和胸腰骶部脑脊液容量变化：一项回顾性磁共振成像研究。

Lumbosacral and thoracolumbosacral cerebrospinal fluid volume changes in neonates, infants, children, and adolescents: A retrospective magnetic resonance imaging study.

作者信息

Jang Young-Eun, Lee Joon-Hee, Seo Yun-Seok, Yoon Hee-Chul, Lee Hyun-Sung, Lee Hyun-Jeong, Jo Hyung-Dong, Lee Ji-Hyun, Kim Jin-Tae

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

Seoul National University College of Medicine, Seoul, Korea.

出版信息

Paediatr Anaesth. 2019 Jan;29(1):92-97. doi: 10.1111/pan.13530. Epub 2018 Nov 23.

DOI:10.1111/pan.13530

PMID:30347458

Abstract

BACKGROUND

The volume of cerebrospinal fluid can affect the pharmacokinetics and pharmacodynamics of local anesthetics for spinal anesthesia and other intrathecal medications.

AIMS

The objective of this study was to estimate the lumbosacral cerebrospinal fluid volume and thoracolumbosacral cerebrospinal fluid volume using magnetic resonance images in pediatric patients from neonates and infants to adolescents.

METHODS

Spinal magnetic resonance images of 500 pediatric patients (age <18 years) were reviewed. The lumbosacral cerebrospinal fluid volumes of 418 patients and thoracolumbosacral cerebrospinal fluid volumes of 248 patients were measured. The relationship between cerebrospinal fluid volumes and age, height, and weight were evaluated. The lumbosacral and thoracolumbosacral cerebrospinal fluid volumes per weight were calculated to elucidate developmental changes.

RESULTS

The lumbosacral and thoracolumbosacral cerebrospinal fluid volumes showed linear correlations with height (r = 0.730 and r = 0.661, respectively), whereas they showed curvilinear correlations with age (r = 0.752 and r = 0.717, respectively) and weight (r = 0.734 and r = 0.734, respectively). The mean lumbosacral cerebrospinal fluid volume per weight (mL/kg) was 0.85 (standard deviation [SD]: 0.19, 95% confidence interval [CI]: 0.81-0.90) in neonates and infants, 0.86 (SD: 0.22, 95% CI: 0.83-0.89) in toddlers and preschoolers, 0.71 (SD: 0.26, 95% CI: 0.66-0.76) in schoolers, and 0.54 (SD: 0.20, 95% CI: 0.49-0.60) in adolescents. The mean thoracolumbosacral cerebrospinal fluid volume per weight (mL/kg) was 1.95 (SD: 0.37, 95% CI: 1.86-2.04) in neonates and infants, 1.82 (SD: 0.41, 95% CI: 1.75-1.88) in toddlers and preschoolers, 1.38 (SD: 0.40, 95% CI: 1.23-1.52) in schoolers, and 0.99 (SD: 0.34, 95% CI: 0.45-1.53) in adolescents.

CONCLUSION

The lumbosacral and thoracolumbosacral cerebrospinal fluid volumes in pediatric patients were much smaller than previously presented values, showing linear correlations with height, and demonstrate curvilinear correlations with age and weight.

摘要

背景

脑脊液的容量会影响用于脊髓麻醉的局部麻醉药以及其他鞘内注射药物的药代动力学和药效学。

目的

本研究的目的是利用磁共振成像估计从新生儿、婴儿到青少年的儿科患者的腰骶部脑脊液容量和胸腰骶部脑脊液容量。

方法

回顾了500例儿科患者（年龄<18岁）的脊髓磁共振成像。测量了418例患者的腰骶部脑脊液容量和248例患者的胸腰骶部脑脊液容量。评估了脑脊液容量与年龄、身高和体重之间的关系。计算每体重的腰骶部和胸腰骶部脑脊液容量以阐明发育变化。

结果

腰骶部和胸腰骶部脑脊液容量与身高呈线性相关（分别为r = 0.730和r = 0.661），而它们与年龄（分别为r = 0.752和r = 0.717）和体重（分别为r = 0.734和r = 0.734）呈曲线相关。新生儿和婴儿每体重的平均腰骶部脑脊液容量（mL/kg）为0.85（标准差[SD]：0.19，95%置信区间[CI]：0.81 - 0.90），幼儿和学龄前儿童为0.86（SD：0.22，95% CI：0.83 - 0.89），学龄儿童为0.71（SD：0.26，95% CI：0.66 - 0.76），青少年为0.54（SD：0.20，95% CI：0.49 - 0.60）。新生儿和婴儿每体重的平均胸腰骶部脑脊液容量（mL/kg）为1.95（SD：0.37，95% CI：1.86 - 2.04），幼儿和学龄前儿童为1.82（SD：0.41，95% CI：1.75 - 1.88），学龄儿童为1.38（SD：0.40，95% CI：1.23 - 1.52），青少年为0.99（SD：0.34，95% CI：0.45 - 1.53）。