Mascalchi M, Arnetoli G, Inzitari D, Dal Pozzo G, Lolli F, Caramella D, Bartolozzi C
Dipartimento di Fisiopatologia Clinica, Universitá di Firenze, Italy.
Acta Radiol. 1993 Nov;34(6):586-92.
Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction.
在11例脑室正常或扩张的患者中，测试了利用平面流入增强的梯度回波电影磁共振序列上导水管脑脊液信号强度的可重复性。对7例正常压力脑积水（NPH）综合征患者在脑脊液分流术前和术后进行了该序列检查。2例导水管脑脊液高信号内出现中央血流信号缺失的患者术后病情改善，分流后血流信号缺失消失。与18名健康对照相比，1例导水管脑脊液最大和最小信号增加的患者也有改善，分流后导水管脑脊液信号明显降低。3例导水管脑脊液值与对照组相似的患者尽管分流后导水管脑脊液最大信号略有下降，但病情并未改善。在最后1例术后病情改善的NPH患者中，未发现与非交通性脑积水一致的明显的导水管脑脊液血流相关强化。采用流入技术的电影磁共振成像可对与血流相关的导水管脑脊液信号变化进行可重复评估，这可能有助于识别对分流有反应的NPH患者。这些患者可能是导水管脑脊液动力增强或导水管梗阻的患者。
