Mamata Y, Muro I, Matsumae M, Komiya T, Toyama H, Tsugane R, Sato O
Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
J Neurosurg. 1998 Apr;88(4):670-8. doi: 10.3171/jns.1998.88.4.0670.
To assess its usefulness in demonstrating cisternal anatomy, the authors investigated magnetic resonance (MR) cisternography in which a heavily T2-weighted turbo spin-echo method was used to visualize normal anatomical fine structures and lesions in the basal cisterns in 20 healthy volunteers and 43 patients. The authors applied peripheral pulse gating, which had been optimized to reduce artifacts in the cisterns attributable to cerebrospinal fluid (CSF) flow.
The detectability of each cranial nerve was determined in healthy volunteers. The first, second, and third nerves and the seventh-eighth nerve complex were clearly visualized in all participants; the fifth nerve was clearly seen in 80% and the sixth cranial nerve in 50%. The fourth nerve and the ninth through 12th nerves were difficult to identify individually, except in some volunteers. To reduce artifacts caused by fast CSF flow, we determined the delays as a function of the time elapsed between two consecutive peaks of pulse wave in a peripheral pulse gate (P-P interval) at which there was reversal of flow direction to minimize the CSF flow-related artifact. Using peripheral pulse gating and a time delay of 30% of the R-R interval, the authors succeeded in minimizing the CSF flow-related artifacts. Magnetic resonance cisternography appears to be very useful for demonstrating intracisternal fine anatomy and enhancing the contours of the juxtacisternal lesion. A minute amount of CSF interposed between lesions and normal structures such as nerves, vessels, or bone structures can be detected by means of this sequence. In patients with facial spasm, axial images and oblique coronal images obtained in a plane parallel to the seventh-eighth cranial nerve complex demonstrated vascular compression in all 13 patients. The MR cisternography finding of compression was confirmed in all nine patients who underwent microvascular decompression.
Magnetic resonance cisternography appears to show great promise for evaluation of patients with neurovascular compression or tumors in and around the basal cisterns; the procedure adds only a small amount of imaging time.
为评估磁共振脑池造影术在显示脑池解剖结构方面的效用，作者对20名健康志愿者和43例患者进行了研究，采用重T2加权快速自旋回波方法来观察基底脑池的正常解剖精细结构和病变。作者应用了外周脉搏门控技术，该技术已进行优化，以减少因脑脊液（CSF）流动导致的脑池伪影。
在健康志愿者中确定每条颅神经的可检测性。所有参与者均能清晰显示第一、第二和第三神经以及第七 - 第八神经复合体；80%的参与者能清晰看到第五神经，50%能清晰看到第六颅神经。除了部分志愿者外，第四神经以及第九至第十二神经难以单独辨认。为减少快速CSF流动引起的伪影，我们根据外周脉搏门控中两个连续脉搏波峰之间的时间间隔（P - P间期）确定延迟时间，此时血流方向发生逆转，以尽量减少与CSF流动相关的伪影。通过使用外周脉搏门控和R - R间期30%的时间延迟，作者成功将与CSF流动相关的伪影降至最低。磁共振脑池造影术似乎在显示脑池内精细解剖结构以及增强脑池旁病变轮廓方面非常有用。通过该序列可检测到病变与神经、血管或骨结构等正常结构之间存在的少量脑脊液。在面肌痉挛患者中，在与第七 - 第八颅神经复合体平行的平面上获得的轴位图像和斜冠状位图像显示，所有13例患者均存在血管压迫。在接受微血管减压术的所有9例患者中，磁共振脑池造影术发现的压迫情况均得到证实。
磁共振脑池造影术在评估基底脑池及其周围神经血管受压或肿瘤患者方面似乎很有前景；该检查仅增加少量成像时间。
