Inao S, Kuchiwaki H, Yoshida J, Furuse M
Department of Neurosurgery, Nagoya University School of Medicine, Japan.
Neurol Res. 1997 Feb;19(1):35-40. doi: 10.1080/01616412.1997.11740769.
We compared measurements of venous blood flow velocity in the superior sagittal sinus (SSS) obtained by magnetic resonance imaging (MRI) and quantitative measurements of cerebral blood flow (CBF) obtained by xenon-enhanced CT, in neurosurgical patients and normal volunteers, to assess the clinical usefulness of MRI for determination of CBF. Flow measurements were obtained in 15 neurosurgical patients and 3 normal volunteers. SSS velocimetry was performed using the direct bolus imaging technique with a 1.5-tesla MRI system near the point of lambda on a sagittal MR image. Quantitative CBF was measured by xenon-enhanced CT and correlated with SSS flow velocity. We also examined the effect of surgical evacuation of a hematoma or cranioplasty in 3 patients, mannitol in 5 patients and acetazolamide in 4 patients by performing SSS velocimetry. The peak SSS flow velocity during the entire cardiac cycle was 27.2 +/- 6.3 cm sec-1 (mean +/- SD) in normal volunteers and 23.5 +/- 8.9 cm sec-1 in patients. The SSS flow velocity increased after surgery. Mean SSS peak flow velocity increased by 24% and 48% at 10 min after administration of mannitol and acetazolamide, respectively. SSS peak flow velocity showed significant linear correlations with both cerebral cortical (r = 0.74) and hemispheric flows (r = 0.73). Our results suggest that SSS flow velocity reflects CBF and that MRI assessment of SSS flow provides a simple method for assessing and monitoring global changes in cerebral hemodynamics.
我们比较了在神经外科患者和正常志愿者中,通过磁共振成像(MRI)获得的上矢状窦(SSS)静脉血流速度测量值与通过氙增强CT获得的脑血流量(CBF)定量测量值,以评估MRI在测定CBF方面的临床实用性。对15名神经外科患者和3名正常志愿者进行了血流测量。使用直接团注成像技术,在矢状面MR图像上靠近人字点处,通过1.5特斯拉MRI系统进行SSS测速。通过氙增强CT测量定量CBF,并将其与SSS血流速度相关联。我们还通过对3例患者进行血肿手术清除或颅骨成形术、5例患者使用甘露醇以及4例患者使用乙酰唑胺,然后进行SSS测速,来研究这些操作的影响。正常志愿者在整个心动周期中的SSS峰值血流速度为27.2±6.3厘米/秒(平均值±标准差),患者为23.5±8.9厘米/秒。术后SSS血流速度增加。在给予甘露醇和乙酰唑胺后10分钟,SSS平均峰值血流速度分别增加了24%和48%。SSS峰值血流速度与大脑皮质血流(r = 0.74)和半球血流(r = 0.73)均呈显著线性相关。我们的结果表明,SSS血流速度反映了CBF,并且MRI对SSS血流的评估为评估和监测脑血流动力学的整体变化提供了一种简单方法。