Automated Quantitation of Spinal CSF Volume and Measurement of Craniospinal CSF Redistribution following Lumbar Withdrawal in Idiopathic Intracranial Hypertension
Automated Quantitation of Spinal CSF Volume and Measurement of Craniospinal CSF Redistribution following Lumbar Withdrawal in Idiopathic Intracranial Hypertension
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DOI：
10.3174/ajnr.a4837
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发表时间：
2016-10-01
影响因子：
3.5
通讯作者：
Lam, B. L.
中科院分区：
文献类型：
--
作者：
Alperin, N.;Bagci, A. M.;Lam, B. L.
背景和目的：磁共振成像定量组织和脑脊液体积的自动化方法适用于颅骨，但不适用于脊柱间室。我们开发了一种用于自动测量脑脊液和脊髓体积的迭代方法来描绘脊髓脑脊液间隙，并将其应用于研究特发性颅内高压患者腰椎停药后脑脊液的再分布。材料和方法：2名健康受试者和8名特发性颅内高压患者在诊断性腰椎穿刺术前、即刻和2周后分别进行了磁共振成像检查。成像包括大脑的T1加权和T2加权序列以及脊柱的T2加权扫描。对4名受试者进行重复扫描以评估测量的重复性。结果：CSF和CSF测量具有较高的重复性，平均变异系数分别为-0.7%~1.4%和-0.7%+/-1.0%。平均脑脊液容量为77.5±8.4mL。基于影像的脑脊液治疗前后的体积差异一直较小，并且与移除的量有很强的相关性(R=0.86，P=0.006)，主要是从腰骶部。结论：对特发性高颅压患者腰椎后脑脊液再分布的自动测量显示，腰椎穿刺术后颅内压的下降主要与脊髓顺应性的增加有关，而不是由于脊髓脑脊液容量的减少和颅脑脊液容量的变化而引起的。
BACKGROUND AND PURPOSE: Automated methods for quantitation of tissue and CSF volumes by MR imaging are available for the cranial but not the spinal compartment. We developed an iterative method for delineation of the spinal CSF spaces for automated measurements of CSF and cord volumes and applied it to study craniospinal CSF redistribution following lumbar withdrawal in patients with idiopathic intracranial hypertension.MATERIALS AND METHODS: MR imaging data were obtained from 2 healthy subjects and 8 patients with idiopathic intracranial hypertension who were scanned before, immediately after, and 2 weeks after diagnostic lumbar puncture. Imaging included T1-weighted and T2-weighted sequences of the brain and T2-weighted scans of the spine. Repeat scans in 4 subjects were used to assess measurement reproducibility. Whole CNS CSF volumes measured prior to and following lumbar puncture were compared with the withdrawn amounts of CSF.RESULTS: CSF and cord volume measurements were highly reproducible with mean variabilities of -0.7% 1.4% and -0.7% +/- 1.0%, respectively. Mean spinal CSF volume was 77.5 +/- 8.4 mL. The imaging-based pre- to post-CSF volume differences were consistently smaller and strongly correlated with the amounts removed (R = 0.86, P = .006), primarily from the lumbosacral region. These differences are explained by net CSF formation of 0.41 +/- 0.18 mL/min between withdrawal and imaging.CONCLUSIONS: Automated measurements of the craniospinal CSF redistribution following lumbar withdrawal in idiopathic intracranial hypertension reveal that the drop in intracranial pressure following lumbar puncture is primarily related to the increase in spinal compliance and not cranial compliance due to the reduced spinal CSF volume and the nearly unchanged cranial CSF volume.