乙状窦后壁脑膜淋巴管与脑脊液中对比剂延迟清除的相关性研究。
Association between the Putative Meningeal Lymphatics at the Posterior Wall of the Sigmoid Sinus and Delayed Contrast-agent Elimination from the Cerebrospinal Fluid.
机构信息
Department of Radiology, Nagoya University Graduate School of Medicine.
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine.
出版信息
Magn Reson Med Sci. 2024 Jan 1;23(1):80-91. doi: 10.2463/mrms.mp.2022-0110. Epub 2023 Jan 19.
PURPOSE
To investigate the characteristics of the putative meningeal lymphatics located at the posterior wall of the sigmoid sinus (PML-PSS) in human subjects imaged before and after intravenous administration (IV) of a gadolinium-based contrast agent (GBCA). The appearance of the PML-PSS and the enhancement of the perivascular space of the basal ganglia (PVS-BG) were analyzed for an association with gender, age, and clearance of the GBCA from the cerebrospinal fluid (CSF).
METHODS
Forty-two patients with suspected endolymphatic hydrops were included. Heavily T2-weighted 3D-fluid attenuated inversion recovery (hT2w-3D-FLAIR) and 3D-real inversion recovery (IR) images were obtained at pre-administration, immediately post-administration, and at 4 and 24 hours after IV-GBCA. The appearance of the PML-PSS and the presence of enhancement in the PVS-BG were analyzed for a relationship with age, gender, contrast enhancement of the CSF at 4 hours after IV-GBCA, and the washout ratio of the GBCA in the CSF from 4 to 24 hours after IV-GBCA.
RESULTS
The PML-PSS and PVS-BG were seen in 23 of 42 and 21 of 42 cases, respectively, at 4 hours after IV-GBCA. In all PML-PSS positive cases, hT2w-3D-FLAIR signal enhancement was highest at 4 hours after IV-GBCA. A multivariate analysis between gender, age, CSF signal elevation at 4 hours, and washout ratio indicated that only the washout ratio was independently associated with the enhancement of the PML-PSS or PVS-BG. The odds ratios (95% CIs; P value) were 4.09 × 10 (2.39 × 10 - 0.07; 0.0078) for the PML-PSS and 1.7 × 10 (1.66 × 10 - 0.174; 0.014) for the PVS-BG.
CONCLUSION
The PML-PSS had the highest signal enhancement at 4 hours after IV-GBCA. When the PML-PSS was seen, there was also often enhancement of the PVS-BG at 4 hours after IV-GBCA. Both observed enhancements were associated with delayed GBCA excretion from the CSF.
目的
研究静脉注射钆基对比剂（GBCA）前后，在人体受试者中位于乙状窦后壁的假定脑膜淋巴管（PML-PSS）的特征。分析 PML-PSS 的外观和基底节血管周围间隙（PVS-BG）的增强与性别、年龄以及 GBCA 从脑脊液（CSF）中的清除率之间的关系。
方法
纳入 42 例疑似内淋巴积水的患者。在给药前、给药后即刻以及静脉注射 GBCA 后 4 小时和 24 小时，获得重 T2 加权 3D 液体衰减反转恢复（hT2w-3D-FLAIR）和 3D 反转恢复（IR）图像。分析 PML-PSS 的外观和 PVS-BG 的增强与年龄、性别、静脉注射 GBCA 后 4 小时 CSF 的对比增强以及静脉注射 GBCA 后 4 至 24 小时 CSF 中 GBCA 的洗脱率之间的关系。
结果
在静脉注射 GBCA 后 4 小时，分别有 23 例和 21 例患者可见 PML-PSS 和 PVS-BG。在所有 PML-PSS 阳性病例中，hT2w-3D-FLAIR 信号增强在静脉注射 GBCA 后 4 小时最高。性别、4 小时 CSF 信号升高、洗脱率之间的多变量分析表明，只有洗脱率与 PML-PSS 或 PVS-BG 的增强独立相关。比值比（95%置信区间；P 值）分别为 PML-PSS 为 4.09×10（2.39×10-0.07；0.0078）和 PVS-BG 为 1.7×10（1.66×10-0.174；0.014）。
结论
静脉注射 GBCA 后 4 小时 PML-PSS 信号增强最高。当观察到 PML-PSS 时，静脉注射 GBCA 后 4 小时 PVS-BG 也经常增强。这两种观察到的增强均与 GBCA 从 CSF 中的延迟排泄有关。
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