Petryaykin A V, Smorchkova A K, Sergunova K A, Akhmad E S, Semenov D S, Kudryavtsev N D, Blokhin I A, Morozov S P, Vladzimirskiy A V, Maer R Yu
Research and Practical Clinical Center of Diagnostics and Telemedicine Technologies, Department of Health Care of Moscow, Moscow, Russia.
Sechenov First Moscow State Medical University Department of Health Care of Moscow, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2019;83(6):64-71. doi: 10.17116/neiro20198306164.
Direct visualization of rapid cerebrospinal fluid movements is a topical task of neurosurgery, which has applications such as evaluating hydrocephalus and the effectiveness of 3rd ventriculostomy.
The study purpose was to evaluate the capabilities of a modified Time-SLIP pulse MRI sequence for visualization of fluid (CSF) movements in the phantom, healthy subject, and patient.
The study was performed in a phantom simulating pulsed CSF movements, healthy volunteers (9 people), and patients without impaired CSF dynamics (12 people), whose data were used to determine mean CSF flow parameters, as well as in 1 patient after 3rd ventriculostomy. A 1.5 T MRI instrument was used. The Time-SLIP parameters were as follows: TR = 8,500 ms; TEeff = 80 ms; Thk = 5.0 mm; tag spacing = 30 mm; NEX 7; inversion time (BBTI) = 2,000/3,000 ms; no cardiosynchronization. Scanning time was 2:16 min. The estimated parameter was the length of motion (LOM) of CSF.
According to a study on a phantom simulating various conditions of oscillatory fluid motion, the mean LOM determination error in the modified Time-SLIP mode was 20%. This technique provided the following LOM data for the cerebral aqueduct (median, 25-75% quartiles): 13.0 (9.5-16.0) mm for BBTI of 2,000ms and 30.2 (23.7-35.3) mm for BBTI of 3,000 ms, i.e. 2.3-fold higher. This difference may be explained by an intense turbulent current leading to rapid CSF exchange between the 3rd and 4th ventricles and prolonged CSF movement during several heart contractions. Quantitative parameters of CSF movement at the C1-C2 level were determined. Additionally, Time-SLIP was used to evaluate performance of a third ventricle fistula.
We have proposed a modified Time-SLIP pulse sequence that does not require cardiosynchronization. The mean relative error in determining the CSF movement distance was 20%. The mean quantitative parameters of CSF movement in the cerebral aqueduct and at the C1-C2 level were obtained. Turbulent CSF flow is found in the cerebral aqueduct, which leads to rapid exchange between the 3rd and 4th ventricles.
直接可视化快速脑脊液流动是神经外科的一项热门任务，其应用包括评估脑积水和第三脑室造瘘术的效果。
本研究旨在评估改良的时间滑动脉冲MRI序列在模拟体、健康受试者和患者中可视化液体（脑脊液）流动的能力。
本研究在模拟脉冲脑脊液流动的模拟体、健康志愿者（9人）和脑脊液动力学未受损的患者（12人）中进行，他们的数据用于确定平均脑脊液流动参数，同时也对1例接受第三脑室造瘘术的患者进行了研究。使用1.5T MRI仪器。时间滑动参数如下：TR = 8500 ms；有效TE = 80 ms；层厚 = 5.0 mm；标记间距 = 30 mm；激励次数7；反转时间（BBTI） = 2000/3000 ms；无心脏同步。扫描时间为2分16秒。估计参数为脑脊液的运动长度（LOM）。
根据对模拟各种振荡液体运动条件的模拟体的研究，改良时间滑动模式下平均LOM测定误差为20%。该技术提供了中脑导水管的以下LOM数据（中位数，25 - 75%四分位数）：BBTI为2000 ms时为13.0（9.5 - 16.0）mm，BBTI为3000 ms时为30.2（23.7 - 35.3）mm，即高出2.3倍。这种差异可能是由于强烈的湍流导致第三和第四脑室之间脑脊液快速交换以及在几次心脏收缩期间脑脊液运动延长所致。确定了C1 - C2水平处脑脊液运动的定量参数。此外，时间滑动用于评估第三脑室瘘的性能。
我们提出了一种无需心脏同步的改良时间滑动脉冲序列。脑脊液运动距离测定的平均相对误差为20%。获得了中脑导水管和C1 - C2水平处脑脊液运动的平均定量参数。发现中脑导水管存在脑脊液湍流，这导致第三和第四脑室之间快速交换。
