论文部分内容阅读
目的探讨MRI成像在低颅压综合征中诊断价值。方法选择经临床拟诊低颅压综合征30例,其中男性13例,女性17例;年龄29~57岁,平均年龄45岁。脑脊液压力均<0.588 k Pa(60 mm H_2O)。进行脑(其中7例增加脊髓)常规MRI成像,采用矢状位及轴位T_2加权三维驱动平衡(T_2WI-3D-DRIVE)序列成像,增强扫描,综合分析其影像特点,进行临床分型。结果原发性19例占63.3%,继发性11例占36.7%。原发性和继发性共同表现为双侧额颞顶枕部硬脑膜及大脑镰、小脑幕均匀增厚(26例),双侧额顶颞枕部及小脑幕下硬膜下积液(15例)。原发性:硬脑膜均匀增厚19例,硬膜下积液11例,脑室缩小、蛛网膜下腔狭窄10例,脑下垂6例,垂体增大5例,5例后颅窝拥挤结构。增强扫描显示硬脑膜弥漫性增厚及明显强化9例,脊柱MRI扫描显示硬脊膜弥漫增厚并明显强化3例。内科治疗1~2个月后复查全部病例基本恢复正常。继发性:双侧额颞顶枕部硬脑膜及大脑镰、小脑幕均匀增厚7例,双侧额顶颞枕部及小脑幕下硬膜下积液4例。脑脊液鼻漏5例;脊椎脑脊液漏6例。显示脑脊液漏管漏口11例。11例继发性手术后复查均见漏管闭塞。结论低颅压综合征具有一定的MRI特征表现,结合脑脊液压测定,可以明确诊断,并可进行临床分型,提供可行治疗方案和对治疗效果准确判断。
Objective To investigate the diagnostic value of MRI in the diagnosis of intracranial hypertension. Methods 30 cases of low intracranial pressure syndrome diagnosed by clinic were selected, including 13 males and 17 females, aged from 29 to 57 years with a mean age of 45 years. Cerebrospinal fluid pressure was <0.588 kPa (60 mm H_2O). Normal brain MRI (including 7 cases of spinal cord enhancement) was performed. MRI was performed using T 2 weighted 3D weighted imaging (T 2 -WI-3D-DRIVE) imaging and enhanced scanning. The imaging features were analyzed comprehensively and the clinical classification was performed. The results of primary 19 cases accounted for 63.3%, secondary 11 cases accounted for 36.7%. Primary and secondary common manifestations of bilateral frontotemporal occipital dural and falx, uniform thickening of the cerebellar (26 cases), bilateral frontoparietal temporal occipital and subdural subdural effusion (15 example). Primary: uniform dural thickening in 19 cases, subdural effusion in 11 cases, ventricular contraction, subarachnoid stenosis in 10 cases, 6 cases of ptosis, pituitary enlargement in 5 cases, 5 cases of posterior fossa crowded structure. Enhanced scan showed dura diffuse thickening and significant enhancement in 9 cases, spinal MRI showed diffuse thickening of the dura and significantly enhanced in 3 cases. Medical treatment 1 to 2 months after the review of all cases returned to normal. Secondary: bilateral frontotemporal occipital dura mater and falx, cerebellar uniform thickening in 7 cases, bilateral frontoparietal temporal occipital and subdural subdural effusion in 4 cases. 5 cases of cerebrospinal fluid rhinorrhea; 6 cases of spinal cerebrospinal fluid leakage. 11 cases of cerebrospinal fluid leakage tube leakage. 11 cases of secondary resection of the leak were found in all occlusion. Conclusion Low intracranial pressure syndrome has some MRI features, combined with cerebrospinal fluid pressure measurement, can be a clear diagnosis, and clinical classification, to provide viable treatment programs and accurate assessment of the treatment effect.