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特发性颅内高压患者磁共振成像表现的临床与影像学相关性。

Clinico-radiological correlation of magnetic resonance imaging findings in patients with idiopathic intracranial hypertension.

机构信息

Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada.

Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada.

出版信息

Neuroradiology. 2020 Jan;62(1):49-53. doi: 10.1007/s00234-019-02288-9. Epub 2019 Sep 10.

Abstract

PURPOSE

Although several studies have reported imaging findings associated with idiopathic intracranial hypertension (IIH), less is known about the correlation between imaging findings and IIH-related symptoms or signs. Our study aimed to determine if clinical features of IIH are correlated with magnetic resonance imaging (MRI) features.

METHODS

A retrospective chart review was conducted on consecutive patients presenting at the neuro-ophthalmology department over the last 15 years. All patients diagnosed with IIH were identified and those with available MRI were included in the final analysis. All MRI images were reviewed by a neuroradiologist blinded to the presenting symptoms and signs. Statistical analysis was performed to determine the correlation between the MRI findings with each clinical symptom or sign.

RESULTS

Thirty-one out of 88 patients with the initial diagnosis of IIH had MRI available and were included in the study. Significant correlations were observed between colour vision and amount of perineural fluid around the optic nerve on MRI (r = - 0.382; p = 0.004), disc assessment and intraocular optic nerve protrusion (r = 0.364; p = 0.004), disc assessment and perineural fluid around the optic nerve (r = 0.276; p = 0.033) and disc assessment and venous sinus stenosis (r = 0.351; p = 0.009).

CONCLUSION

Our study highlights correlations between imaging and clinical findings of IIH. MRI findings in IIH may be useful in ruling out ominous causes of intracranial pressure and risk stratifying ophthalmologic intervention and management of patients with headaches possibly due to IIH.

摘要

目的

尽管已有多项研究报道了与特发性颅内高压(IIH)相关的影像学表现,但关于影像学表现与 IIH 相关症状或体征之间的相关性知之甚少。本研究旨在确定 IIH 的临床特征是否与磁共振成像(MRI)特征相关。

方法

对过去 15 年来神经眼科就诊的连续患者进行回顾性病历审查。确定所有诊断为 IIH 的患者,并对有 MRI 检查结果的患者进行最终分析。所有 MRI 图像均由一名神经放射科医生进行盲法评估,该医生对患者的临床表现和体征不知情。采用统计学分析方法确定 MRI 表现与每个临床症状或体征之间的相关性。

结果

88 例初始诊断为 IIH 的患者中有 31 例 MRI 检查结果可用,被纳入本研究。在 MRI 上观察到以下特征之间存在显著相关性:色觉与视神经周围神经鞘液量(r=-0.382;p=0.004)、视盘评估与眼内视神经突出(r=0.364;p=0.004)、视盘评估与视神经周围神经鞘液(r=0.276;p=0.033)以及视盘评估与静脉窦狭窄(r=0.351;p=0.009)。

结论

本研究强调了 IIH 影像学与临床表现之间的相关性。MRI 表现可能有助于排除颅内压升高的严重原因,并对可能因 IIH 导致头痛的患者进行眼科干预和管理进行风险分层。

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