Yoshihara M, Tsunoda A, Sato K, Kanayama S, Calderon A
Department of Neurosurgery, Ohta General Hospital, Japan.
Acta Neurochir Suppl. 1998;71:371-4. doi: 10.1007/978-3-7091-6475-4_107.
Differential diagnosis of NPH and brain atrophy is sometimes difficult. Recently, a new method using MRI was introduced as a noninvasive, direct technique for the measurement of intracranial CSF volume. Using this new technique, we measured the intracranial and ventricle CSF volume in patients with enlarged ventricles in order to differentiate between NPH and brain atrophy. Ten healthy volunteers (control group) and 21 patients with enlarged ventricles were enrolled in this study. Eleven out of 21 patients were clinically diagnosed as having NPH (shunted group) and the remaining 10 patients were considered to have cerebral atrophy (non-shunted group). Intracranial and ventricular CSF volume in each case were measured by 3D FASE (Fast Asymmetric Spine-Echo) MR imaging sequence with region growing method. Ventricular/intracranial CSF volume ratio was also calculated. Ten out of 11 patients showed improvement in clinical symptoms and/or dementia scale after shunting. Our results clearly indicate that the ventricular volume in the shunted group was enlarged and that the ventricular/intracranial CSF ratio was significantly high. Thus we concluded that enlarged ventricle with high ventricular/intracranial CSF volume ratio strongly suggests NPH.
正常压力脑积水（NPH）与脑萎缩的鉴别诊断有时存在困难。最近，一种使用磁共振成像（MRI）的新方法被引入，作为一种测量颅内脑脊液体积的非侵入性直接技术。使用这种新技术，我们测量了脑室扩大患者的颅内和脑室脑脊液体积，以区分NPH和脑萎缩。本研究纳入了10名健康志愿者（对照组）和21名脑室扩大的患者。21名患者中有11名临床诊断为NPH（分流组），其余10名患者被认为患有脑萎缩（非分流组）。通过具有区域生长法的三维快速不对称自旋回波（3D FASE）磁共振成像序列测量每种情况下的颅内和脑室脑脊液体积。还计算了脑室/颅内脑脊液体积比。11名患者中有10名在分流后临床症状和/或痴呆量表有所改善。我们的结果清楚地表明，分流组的脑室体积增大，脑室/颅内脑脊液比值显著升高。因此，我们得出结论，脑室扩大且脑室/颅内脑脊液体积比高强烈提示NPH。
