大脑脊髓液压力,内形态和静脉血液动力学之间的相互关系通过4D流动MRI研究
Florian F Schuchardt1,2, Axel J Krafft3, Lidia Miguel Telega4,5
1Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. florian.schuchardt@googlemail.com.
Clinical neuroradiology
|January 26, 2024
概括
变化的脑脊液 (CSF) 压力会影响内静脉结构和血液流动. 在自发性内低血压 (SIH) 中治疗CSF泄漏减少了静脉体积和流量,增加了视神经外直径 (ONSD).
科学领域:
- 神经成像是一种神经成像.
- 神经外科 神经外科
- 血管神经学 血管神经学
背景情况:
- 异常性内高血压 (IIH) 和自发性内低血压 (SIH) 涉及脑脊液 (CSF) 压力失调.
- 内静脉系统的改变与这些情况有关.
- 非侵入性标记物,如视神经外直径 (ONSD),可能反映CSF压力变化.
研究的目的:
- 量化脑脊液压力变化对IIH和SIH内静脉形态和血液动力学的影响.
- 在治疗SIH的根本原因后,评估这些静脉变化的可逆性.
主要方法:
- 这是一项前性研究,涉及11名IIH患者,11名对照患者和9名SIH患者.
- 多参数MRI,包括4D流MRI,TOF和HASTE,用于评估静脉体积,血液流量和速度.
- 测量ONSD是作为CSF压力变化的替代品.
- SIH患者通过神经外科手术关闭了脊柱持续性泄漏.
主要成果:
- 基线静脉鼻体积在各组中是相似的.
- 在SIH中CSF泄漏关闭后,鼻体积和上斜鼻血流量下降 (p=0.067),而ONSD显著增加 (p=0.003).
- 在患有较高的CSF压力 (IIH vs.对照/SIH治疗后) 的患者中,在上部斜鼻观察到较低的血流.
结论:
- 多参数MRI有效地证明了CSF压力,静脉体积,血液动力学和ONSD之间的相互作用.
- 在SIH中成功关闭CSF泄漏导致内静脉体积降低和上部斜侧鼻血流,同时增加了ONSD.
- 基线4D流量MRI参数由于重叠的血液动力学,没有区分IIH,SIH和对照组.
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