[1]张鸿日,彭静华,李小潘.相位对比法脑脊液电影磁共振成像在诊断脑室-腹腔分流装置梗阻中的应用[J].中国临床神经外科杂志,2017,(07):467-469.[doi:10.13798/j.issn.1009-153X.2017.07.007]
　ZHANG Hong-ri,PENG Jing-hua,LI Xiao-pan..Application of cine phase contrast MRI to diagnosis of shunt catheter obstruction in patients with hydrocephalus after ventriculoperitoneal shunt[J].,2017,(07):467-469.[doi:10.13798/j.issn.1009-153X.2017.07.007]
点击复制

相位对比法脑脊液电影磁共振成像在诊断脑室-腹腔分流装置梗阻中的应用()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年07期
页码:
467-469
栏目:
论著
出版日期:
2017-07-20

文章信息/Info

Title:
Application of cine phase contrast MRI to diagnosis of shunt catheter obstruction in patients with hydrocephalus after ventriculoperitoneal shunt
文章编号:
1009-153X（2017）07-0467-03
作者:
张鸿日; 彭静华; 李小潘
471003 河南洛阳，河南科技大学第一附属医院神经外科（张鸿日），神经内科（彭静华），核磁共振室（李小潘）
Author(s):
ZHANG Hong-ri1;  PENG Jing-hua2;  LI Xiao-pan3.
1. Department of Neurosurgery, The First Affiliated Hospital, Henan University of Science and Technology, Luoyang 471003, China;
2. Department of Neurology, The First Affiliated Hospital, Henan University of Science and Technology, Luoyang 471003, China;
3. MRI Room, The First Affiliated Hospital, Henan University of Science and Technology, Luoyang 471003, China
关键词:
脑室-腹腔分流术; 相位对比法脑脊液电影磁共振成像; 分流管梗阻; 诊断
Keywords:
Hydrocephalus;  Cine PC MRI;  Ventriculoperitoneal shunt;  Flow velocity
分类号:
R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.07.007
文献标志码:
A
摘要:
目的 探讨相位对比法脑脊液电影磁共振成像（PC cine MRI）在诊断脑室-腹腔分流装置梗阻中的价值，为诊断脑室-腹腔分流装置梗阻提供一种新方法。方法 体外试验中将生理盐水以0、2.17、10、20 ml/h速度流经脑室-腹腔分流管，应用PC cine MRI对引流管内液体进行定向观察，CSF-QFlow软件进行定量分析。应用同样的方法对8例怀疑分流管梗阻的病人进行流量检测并进行分析，将疑似梗阻病人的脑脊液的流速，与体外试验速度2.17 ml/h的检测结果进行对照分析。结果 体外试验时，与流速为2.17、10、20 ml/h相应值比，流速为0 ml/h的MRI检测值均明显降低（P<0.01）。根据临床拔管指征（每天分流量小于50 ml，换算流速为2.17 ml/h）作为梗阻的标准，6例病人均低于此标准，可诊断为梗阻，此方法诊断结果与临床治疗结果吻合率为100%。结论 PC cine MRI技术简单、无创、可靠，可为诊断分流装置梗阻提供参考。
Abstract:
Objective To provide a method for diagnosing the obstruction of ventriculoperitoneal shunt (VPS) device in the patient with hydrocephalus. Methods The flow of normal saline was qualitatively observed and quantitatively analyzed respectively by cine phase contrast (PC) MRI and CSF-Q Flow software when it passed through the silicon catheter at speeds of 0 ml/h, 2.17 ml/h, 10 ml/h and 20 ml/h. The flow of CSF in the shunt catheters were determined and analyzed by cine PC MRI and CSF-Q Flow software in 8 patients with hydrocephalus, in whom the shunt catheters were suspected to be obstructed after the VPS. Results The velocity of fluid flow in the catheter was significantly higher in the 2.17 ml/h, 10 ml/h and 20 ml/h groups than that in 0 ml/h group (P<0.01).Of 8 patients with hydrocephalus examined by cine PC MRI and analyzed by CSF-Q Flow software, 6 had the shunt catheter obstruction and 2 not. The coincident rate of diagnosis made by cine PC MRI with that proved by the operation and treatment outcomes was 100%. Conclusion Cine PC MRI is a simple, noninvasive and reliable method to diagnose shunt catheter obstruction after VPS in the patients with hydrocephalus.

参考文献/References:

[1] Mizrahi CJ, Spektor S, Margolin E, et al. Ventriculoperito- neal shunt malfunction caused by proximal catheter fat obstruction [J]. J Clin Neurosci，2016,30: 120-123.
[2] 云德波，张　逵，范润金，等. 脑室-腹腔分流术后分流不 畅的原因分析及处理[J]. 中国临床神经外科杂志， 2016， 21：92-93.
[3] 孙　强. 脑室端梗阻致脑室-腹腔分流术失败的原因及 防治[J]. 中国临床神经外科杂志，2016，21：620-621
[4] ElSankari S, Balédent O, van Pesch V. Concomitant analysis of arterial, venous, and CSF flows using phase-contrast MRI: a quantitative comparison between MS patients and healthy controls [J]. Cereb Blood Flow Metab, 2013, 33: 1314-1321.
[5] Rüegger CM, Makki MI, Capel C, et al. An innovative approach to investigate the dynamics of the cerebrospinal fluid in the prepontine cistern: a feasibility study using spatial saturation-prepared cine PC-MRI [J]. Eur J Radiol Open，2014, 16: 14-21.
[6] 宋　杨，谭晓天，王雪美. 3.0T MRI对中脑导水管脑脊液 流动的研究[J]. 磁共振成像，2015，6：172-177.
[7] 陈　真，李广庆，华　扬，等. 早期发现脑室-腹腔分流管 堵塞的三种检测方法[J]. 中国脑血管病杂志，2004，1 （9）：405-407.
[8] Bargallo N, Olondo L, Garcia AI, et al. Functional analysis of third ventriculostomy patency by quantification of CSF stroke volume by using cine phase-contrast MR imaging [J]. Am J Neuroradiol, 2005, 26: 2514-2521.
[9] Forner Giner J, Sanz-Requena R, Flórez N, et al. Quantita- tive phase-contrast MRI study of cerebrospinal fluid flow: a method for identifying patients with normal-pressure hydro- cephalus [J]. Neurologia, 2014, 29: 68-75.

相似文献/References:

[1]周　平　邓　燕　王　辉　罗　杰　胡钧涛　刘开军　李安荣　李新建.脊髓脊膜膨出合并脑积水分流手术时机的选择[J].中国临床神经外科杂志,2015,(11):692.[doi:10.13798/j.issn.1009-153X.2015.11.017]
[2]娄元华　李小勇　陈红伟　潘栋超　解东成　刘东升.婴儿脑积水分流术后硬膜下积液的临床分析[J].中国临床神经外科杂志,2016,(04):245.[doi:10.13798/j.issn.1009-153X.2016.04.019]
[3]云德波　张　逵　范润金　唐　辉　谯　飞　陈华轩.脑室-腹腔分流术后分流不畅的原因分析及处理[J].中国临床神经外科杂志,2016,(02):92.[doi:10.13798/j.issn.1009-153X.2016.02.011]
　YUN De-bo,ZHANG Kui,FAN Run-Jin,et al.Analysis of cause and countermeasures of poor diversion after ventriculoperitoneal shunt in patients with hydrocephalus[J].,2016,(07):92.[doi:10.13798/j.issn.1009-153X.2016.02.011]
[4]张清超　陈新生.腰大池-腹腔分流术治疗交通性脑积水的疗效观察[J].中国临床神经外科杂志,2016,(02):103.[doi:10.13798/j.issn.1009-153X.2016.02.015]
[5]张宏兵　苏宝艳　王晓峰　马　青　杨晓亮.原发性正常压力脑积水术前评估的临床价值[J].中国临床神经外科杂志,2016,(01):47.[doi:10.13798/j.issn.1009-153X.2016.01.017]
[6]张　源　王文浩　林　洪　林俊明　黄　巍　李　君　罗　飞　胡连水.侧脑室后角穿刺术的新方法介绍[J].中国临床神经外科杂志,2016,(01):26.[doi:10.13798/j.issn.1009-153X.2016.01.009]
[7]郑安锡　黄晓明　袁晓东　唐文华　陈世平　程　文　张　瑜.两种术式治疗交通性脑积水的疗效分析[J].中国临床神经外科杂志,2015,(09):563.[doi:10.13798/j.issn.1009-153X.2015.09.020]
[8]于　峰　王　路　门学忠　朱　冰　孙希炎.重度脑积水脑室-腹腔分流术后继发硬膜下血肿2例[J].中国临床神经外科杂志,2015,(03):192.[doi:10.13798/j.issn.1009-153X.2015.03.025]
[9]任瑞明　成文平　楚鹏飞　张　伟　李会兵　张　坤.脑室-腹腔分流术治疗脑积水48例[J].中国临床神经外科杂志,2015,(01):50.[doi:10.13798/j.issn.1009-153X.2015.01.017]
[10]郑　虎　张红波　袁辉胜.脑室-腹腔分流术后感染16例保守治疗[J].中国临床神经外科杂志,2016,(08):495.[doi:10.13798/j.issn.1009-153X.2016.08.019]

备注/Memo

备注/Memo:
基金项目：河南洛阳市青年医学科技创新联合专项资金项目(1503008A-17)
更新日期/Last Update: 2017-07-25