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目的了解脑积水患儿行神经内镜下三脑室底造瘘术后的MRI相位对比电影的表现,评价其用于术后疗效判断的价值。方法 12例脑积水患儿行三脑室底造瘘术前后均行MRI常规序列扫描及相位对比电影检查,评估中脑导水管及三脑室造瘘口的脑脊液流动情况,测量脑脊液流动动力学指标(峰值流速、流量及流动波形),比较其前后的差异。结果 12例脑积水患儿造瘘口脑脊液流动在一个心动周期内表现为双向运动,与正常导水管流动波形相似。其中三脑室造瘘术前7例梗阻性脑积水患儿中脑导水管脑脊液双向流动减弱或消失,表现为低动力学改变;5例交通性脑积水患儿三脑室底造瘘术前中脑导水管脑脊液双向流动明显加快,表现为高动力学改变。三脑室底造瘘术后中脑导水管脑脊液流动不规则,循环减慢。12例患儿术后幕上脑室均较术前缩小,其中8例分别于术后半年及术后1年复查见脑室进一步缩小。结论 MRI相位对比电影法为脑积水患儿行三脑室底造瘘术提供可靠的影像学观察手段,可以作为评价三脑室底造瘘术疗效的有效方法。
Objective To investigate the performance of contrast phase contrast film after endoscopic three-ventricle endoscopic fistula in children with hydrocephalus and to evaluate the value of this method for judging postoperative efficacy. Methods 12 cases of children with hydrocephalus underwent three-ventricle fistula before and after MRI scan and phase contrast film were performed to assess cerebrospinal fluid flow in the midbrain aqueduct and the third ventricle fistula to measure cerebrospinal fluid flow dynamics Indicators (peak flow rate, flow rate and flow waveform) were compared before and after the difference. Results The flow of cerebrospinal fluid in 12 cases of hydrocephalus was bi-directional in one cardiac cycle, similar to that of normal aqueduct. Among them, 7 cases of obstructive hydrocephalus before three-ventrostomy were weakened or disappeared in bilateral cerebral cerebrospinal fluid of cerebrocephalic canal, which showed low dynamic changes. Five cases of pedunculated third ventricle fistula with traffic hydrocephalus Midbrain aqueduct two-way flow of cerebrospinal fluid was significantly accelerated, showed high dynamic changes. Third ventricle fistula midbrain aqueduct cerebrospinal fluid flow irregular, slow cycle. Twelve cases of supratentorial supratentorial ventricle decreased compared with that before operation, of which 8 cases were further reduced after six months and one year after operation. Conclusion MRI phase contrast film method for children with hydrocephalus in children with three ventricle fundus fistula to provide a reliable means of imaging studies can be used as an effective method to evaluate the efficacy of three ventricle fistula.