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目的采用MRI结合半自动软件全定量评估脑积水患者颅内脑脊液的分布特点。方法对交通性脑积水患者(A组,34例)、非交通性脑积水患者(B组,24例)以及正常志愿者(C组,30例)分别于MRI上采用三维扰相自旋回波(SPACE)序列矢状位扫描,然后通过半自动软件计算枕骨大孔以上总脑脊液、脑室脑脊液、蛛网膜下腔脑脊液体积以及脑室占总脑脊液或蛛网膜下腔脑脊液的体积比。通过脑脊液三维容积成像,将侧脑室前部额叶、侧脑室体部额顶叶、侧脑室后方枕叶蛛网膜下腔脑脊液的狭窄程度按照4级分类法分级。结果 C组侧脑室后方枕叶蛛网膜下腔较窄,A组侧脑室体部额顶叶蛛网膜下腔变窄较明显,B组则全部蛛网膜下腔变窄。A组和B组总脑脊液、脑室脑脊液、蛛网膜下腔脑脊液体积以及脑室与蛛网膜下腔脑脊液或总脑脊液体积比均大于C组(P<0.01);而A组与B组间上述各观察指标亦有统计学差异(P<0.01)。结论正常成人与不同类型脑积水患者侧脑室旁蛛网膜下腔脑脊液具有不同分布特点;通过评估脑脊液的分布及体积比例可以帮助诊断脑积水。
Objective To evaluate the distribution of intracranial cerebrospinal fluid in patients with hydrocephalus by MRI and semi-automatic software. Methods Three-dimensional perturbation was performed on MRI in patients with communicating hydrocephalus (group A, 34 cases), non-communicating hydrocephalus (group B, 24 cases), and normal volunteers (group C, 30 cases) Spinach (SPACE) sequence sagittal scan, and then calculated by semi-automatic software foramen greater than the total cerebrospinal fluid, cerebrospinal fluid, subarachnoid cerebrospinal fluid volume and the total cerebrospinal fluid or subarachnoid cerebrospinal fluid volume ratio. By cerebrospinal fluid three-dimensional volume imaging, the anterior frontal lobe of lateral ventricle, frontal parietal lobe of lateral ventricle, and posterior lateral cerebral occipital subarachnoid cerebrospinal fluid stenosis were graded according to 4-level classification. Results In group C, the suboccipital space of the posterior lateral occipital lobe was narrower, while the frontal parietal subarachnoid space of lateral ventricle of group A was more narrowed. In group B, the subarachnoid space was narrowed. The volume of cerebrospinal fluid, cerebrospinal fluid and subarachnoid cerebrospinal fluid in CSF group A and group B were significantly higher than those in group C (P <0.01) There are also statistically significant differences (P <0.01). Conclusion Normal adult and hydrocephalus patients with different types of subarachnoid cerebrospinal fluid have different distribution; evaluation of cerebrospinal fluid distribution and volume ratio can help diagnose hydrocephalus.