Pediatric Neurosurgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.
Department of Physics and Astronomy and Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Aarhus, Denmark.
Neuroradiology. 2019 Jul;61(7):825-832. doi: 10.1007/s00234-019-02203-2. Epub 2019 May 3.
Cerebellar herniation in Chiari patients can be dynamic, following the cerebrospinal fluid pulsatility during the cardiac cycle. We present a voxel intensity distribution method (VIDM) to automatically extract the pulsatility-dependent herniation in time-resolved MRI (CINE MRI) and compare it to the simple linear measurements. The degree of herniation is furthermore compared on CINE and static sequences, and the cerebellar movement is correlated to the presence of hydrocephalus and syringomyelia.
The cerebellar movement in 27 Chiari patients is analyzed with VIDM and the results were compared to linear measurements on an image viewer (visual inspection, VI) using a paired t test. Second, an ANOVA test is applied to compare the degree of herniation on static 3D MRI and CINE. Finally, the Pearson's correlation coefficient is calculated for the correlation between cerebellar movement and the presence of hydrocephalus and syringomyelia.
VIDM showed significant movement in 85% of our patients. Assuming that movement < 1 mm cannot be detected reliably on an image viewer, VI identified movement in 29.6% of the patients (p = 0.002). The herniation was greater on static sequences than on CINE in most cases, but this was not statistically significant. The cerebellar movement was not correlated with hydrocephalus or syringomyelia (Pearson's coefficient < 0.3).
VIDM is a sensitive method to detect tissue movement on CINE MRI and could be used for Chiari patients, but also for the evaluation of cyst membranes, ventriculostomies, etc. The cerebellar movement appears not to correlate with hydrocephalus and syringomyelia in Chiari patients.
小脑扁桃体下疝患者的小脑疝出可随脑脊液在心动周期中的搏动而发生动态变化。我们提出了一种体素强度分布方法（VIDM），用于自动提取时间分辨 MRI（电影 MRI）中搏动依赖性疝出，并将其与简单的线性测量进行比较。进一步比较电影 MRI 和静态序列上的疝出程度，并将小脑运动与脑积水和脊髓空洞症的存在相关联。
使用 VIDM 分析 27 例 Chiari 患者的小脑运动，并使用配对 t 检验将结果与图像查看器（视觉检查，VI）上的线性测量进行比较。其次，应用方差分析（ANOVA）检验比较静态 3D MRI 和电影 MRI 上疝出的程度。最后，计算小脑运动与脑积水和脊髓空洞症存在之间的 Pearson 相关系数。
VIDM 显示我们的 85%患者存在明显的运动。假设在图像查看器上无法可靠地检测到运动<1mm，VI 在 29.6%的患者中识别到运动（p=0.002）。在大多数情况下，静态序列上的疝出程度大于电影 MRI 上的疝出程度，但这没有统计学意义。小脑运动与脑积水或脊髓空洞症无关（Pearson 系数<0.3）。
VIDM 是一种检测电影 MRI 上组织运动的敏感方法，可用于 Chiari 患者，也可用于评估囊肿膜、脑室造口术等。小脑运动似乎与 Chiari 患者的脑积水和脊髓空洞症无关。
