[1]刘晓虎,罗霜,付兵,等.PC-MRI在Ⅰ型Chiari畸形枕大池成形术后疗效评估中的应用[J].中国临床神经外科杂志,2022,27(01):22-24.[doi:10.13798/j.issn.1009-153X.2022.01.008]
 LIU Xiao-hu,LUO Shuang,FU Bing,et al.Clinical application of phase-contrast magnetic resonance image in postoperative evaluation of Chiari malformation type Ⅰ[J].,2022,27(01):22-24.[doi:10.13798/j.issn.1009-153X.2022.01.008]
点击复制

PC-MRI在Ⅰ型Chiari畸形枕大池成形术后疗效评估中的应用()
分享到:

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

卷:
27
期数:
2022年01期
页码:
22-24
栏目:
论著
出版日期:
2022-01-15

文章信息/Info

Title:
Clinical application of phase-contrast magnetic resonance image in postoperative evaluation of Chiari malformation type Ⅰ
文章编号:
1009-153X(2022)01-0022-03
作者:
刘晓虎 罗霜 付兵 徐世康 勒都晓兰
611130,成都市第五人民医院放射科(刘晓虎、付兵、徐世康、勒都晓兰),神经外科(罗霜)
Author(s):
LIU Xiao-hu1 LUO Shuang2 FU Bing1 XU Shi-kang1 Ledu Xiao-lan1.
1. Department of Radiology, The Fifth People's Hospital of Chengdu, Chengdu 611130, China; 2. Department of Neurosurgery, The Fifth People's Hospital of Chengdu, Chengdu 611130, China
关键词:
Chiari畸形枕大池成形术相位对比脑脊液电影成像疗效评估
Keywords:
Chiari malformation type Ⅰ Cisternaplasty Phase-contrast magnetic resonance image Efficacy evaluation
分类号:
R 742.8+2
DOI:
10.13798/j.issn.1009-153X.2022.01.008
文献标志码:
A
摘要:
目的探讨磁共振相位对比电影成像(PC-MRI)技术在Ⅰ型Chiari畸形枕大池成形术后疗效评估中的应用价值。方法2018年6月至2020年12月前瞻性收集Ⅰ型Chiari畸形21例,均行枕大池成形术治疗,术前及术后6个月行PC-MRI检查,分析中脑导水管及脑桥腹侧脑脊液平均流量(MF)、头向峰值流速(Vumax)及足向峰值流速(Vdmax)。术后6个月,根据症状缓解与否,分为症状缓解组和无缓解组。结果术后6个月,15例术后症状消失或缓解(缓解组),6例症状无明显改善(无缓解组)。缓解组中脑导水管、脑桥腹侧Vdmax和Vumax较术前均明显降低(P<0.05),而MF则明显增加(P<0.05)。无缓解组手术前后中脑水管及脑桥腹侧脑脊液MF、Vdmax和Vumax均明显变化(P>0.05)。结论PC-MRI可定量分析脑脊液流动情况,对Ⅰ型Chiari畸形术后疗效评估具有一定价值。
Abstract:
Objective To explore the application value of phase-contrast magnetic resonance image (PC-MRI) in the evaluation of postoperative efficacy of cisternaplasty for the patients with Chiari malformation type Ⅰ (CM-Ⅰ). Methods A total of 21 patients with CM-Ⅰ were prospectively recruited from June 2018 to December 2020. All the patient underwent cisternaplasty. The PC-MRI examination was performed before and 6 months after the surgery to evaluate the cerebrospinal fluid (CSF) flow in the aqueduct of midbrain and ventral pons, and the parameters included mean flux (MF), maximum peak velocity (Vmax), Vumax and Vdmax. Results Six months after the operation, symptom relief was achieved in 15 patients (symptom relief group), and 6 not (no relief group). The MF, Vumax and Vdmax of CSF flow in the aqueduct of midbrain and ventral pons of the patients in symptom relief group were significantly decreased and MF was significantly increased 6 moths after the operation (P<0.01). The MF, Vmax, Vumax and Vdmax of CSF flow in the aqueduct of midbrain and ventral pons of the patients in no relief group did not change significantly 6 months after the surgery (P> 0.05). Conclusions PC-MRI can quantitatively analyze the CSF flow, which has certain value in evaluating the postoperative curative effect of the cisternaplasty for the patients with CM-Ⅰ.

参考文献/References:

[1]Mukherjee S, Kalra N, Warren D, et al. Chiari I malformation and altered cerebrospinal fluid dynamics-the highs and the lows[J]. Childs Nerv Syst, 2019, 35(10): 1711-1717.
[2]Sadique SI, Pandey P, Chaudhuri AK. Cerebrospinal fluid flowmetry in pediatric patients with chiari malformation Ⅰ with surgical implications[J]. World Neurosurg, 2020, 135:e83-e86.
[3]Patel RP, Sitton CW, Ketonen LM, et al. Phase-contrast cerebrospinal fluid flow magnetic resonance imaging in qualitative evaluation of patency of CSF flow pathways prior to infusion of chemotherapeutic and other agents into the fourth ventricle[J]. Childs Nerv Syst, 2018, 34(3): 481-486.
[4]Korbecki A, Zimny A, Podgórski P, et al. Imaging of cerebrospinal fluid flow: fundamentals, techniques, and clinical applications of phase-contrast magnetic resonance imaging [J]. Pol J Radiol, 2019, 84: e240-e250.
[5]Lawrence BJ, Luciano M, Tew J, et al. Cardiac-related spinal cordtissue motion at the foramen magnum is increased in patients with type Ⅰ Chiari malformation and decreases post decompression surgery[J]. World Neurosurg, 2018,116: e298-e307.
[6]Zhang L, Yi Z, Duan H, et al. A novel autologous duraplasty in situ technique for the treatment of Chiari malformation Type I[J]. J Neurosurg, 2017, 126(1): 91-97.
[7]Holly LT, Batzdorf U. Chiari malformation and syringomyelia [J]. J Neurosurg Spine, 2019, 31(5): 619 -628.
[8]Goh CH, Hamzah MR, Kandasamy R, et al. The use of magnetic resonance phase-contrast cine in Chiari malformation with syringomyelia[J]. Med J Malaysia, 2020, 75(6):666-671.
[9]K?nig RE, Stucht D, Baecke S, et al. Phase-contrast mri detection of ventricular shunt csf flow: proof of principle[J].J Neuroimaging, 2020, 30(6): 746-753.
[10]陆笑非,舒健,杨述根,等. PC-MRI在Ⅰ型Chiari畸形伴脊髓空洞症患者枕大池成形术中的应用[J]. 中国医学影像技术,2017,33(5):688-692.
[11]Bond AE, Jane Sr JA, Liu KC, et al. Changes in cerebrospinal fluid flow assessed using intraoperative MRI during posterior fossa decompression for Chiari malformation[J]. J Neurosurg, 2015, 122(5): 1068-1075.
[12]Xu H, Chu L, He R, et al. Posterior fossa decompression with and without duraplasty for the treatment of Chiari malformation type I-a systematic review and meta-analysis [J]. Neurosurg Rev, 2017, 40(2): 213-221.

相似文献/References:

[1]刘 彬 王振宇 谢京诚 李振东 马长城 陈晓东.Chiari畸形合并脊髓空洞症术中不同大小后颅窝减压窗近期疗效的比较[J].中国临床神经外科杂志,2016,(01):10.[doi:10.13798/j.issn.1009-153X.2016.01.004]
 LIU Bin,WANG Zhen-yu,XIE Jing-chen,et al.Effect of decompression window area of posterior fossa on short-term surgical outcomes in Chiari malformation patients with syringomyelia[J].,2016,(01):10.[doi:10.13798/j.issn.1009-153X.2016.01.004]
[2]黄忻涛 综述,王振宇 审校.Chiari畸形外科治疗进展[J].中国临床神经外科杂志,2017,(02):112.[doi:10.13798/j.issn.1009-153X.2017.02.019]
[3]邱军,范涛,赵新岗,等.Chiari畸形合并颅底凹陷症1例[J].中国临床神经外科杂志,2017,(02):121.[doi:10.13798/j.issn.1009-153X.2017.02.023]
[4]修波,李萃萃,林和璞,等.Chiari畸形113例手术治疗分析[J].中国临床神经外科杂志,2017,(07):460.[doi:10.13798/j.issn.1009-153X.2017.07.005]
 XIU Bo,LI Cui-cui,LIN He-pu,et al.Microsurgery for Chiari malformations (report of 113 cases)[J].,2017,(01):460.[doi:10.13798/j.issn.1009-153X.2017.07.005]
[5]康宏达 卢二勤 宋 凯 李 杰.Chiari畸形术后寰枕交界区稳定性的临床观察[J].中国临床神经外科杂志,2018,(03):204.[doi:10.13798/j.issn.1009-153X.2018.03.023]
[6]强京灵 田德洲 张远征.Chiari畸形Ⅰ型合并睡眠呼吸暂停综合征的手术治疗分析[J].中国临床神经外科杂志,2018,(08):529.[doi:doi:10.13798/j.issn.1009-153X.2018.08.006]
 QIANG Jing-ling,TIAN De-zhou,ZHANG Yuan-zheng..Microsurgery for Chiari malformation type Ⅰassociated with central sleep apnea hypopnea sydrome (report of 6 cases)[J].,2018,(01):529.[doi:doi:10.13798/j.issn.1009-153X.2018.08.006]
[7]何运森 郑 涛 张孙鑫 李肖越 综述 吴 波 审校.Chiari畸形Ⅰ型合并脊髓空洞症的诊疗进展[J].中国临床神经外科杂志,2019,(01):55.[doi:10.13798/j.issn.1009-153X.2019.01.018]

更新日期/Last Update: 2022-01-18