Quantitative Analysis of Cerebrospinal Fluid Pressure Gradients in Healthy Volunteers and Patients with Normal Pressure Hydrocephalus
Quantitative Analysis of Cerebrospinal Fluid Pressure Gradients in Healthy Volunteers and Patients with Normal Pressure Hydrocephalus
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DOI：
10.2176/nmc.oa.2014-0339
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发表时间：
2015-08-01
影响因子：
1.9
通讯作者：
Kuroda, Kagayaki
中科院分区：
文献类型：
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作者：
Hayashi, Naokazu;Matsumae, Mitsunori;Kuroda, Kagayaki
磁共振成像（MRI）不仅可以描绘解剖信息，还可以描绘速度和压力梯度等生理因素。测量这些生理因素对于了解脑脊液 (CSF) 环境是必要的。在这项研究中，我们量化了脑脊液空间各个部分的脑脊液运动，确定了脑脊液环境随衰老的变化，并比较了特发性正常压力脑积水（iNPH）患者和健康老年志愿者之间的脑脊液压力梯度。 57 名健康志愿者和 6 名 iNPH 患者接受了四维 (4D) 相位对比 (PC) MRI。观察脑脊液运动并量化脑脊液空间中脑脊液的压力梯度。在健康志愿者中，观察到不均匀的脑脊液运动，其中颅骨中心的压力梯度显着增加，而颅骨周边的压力梯度逐渐减小。例如，脑干腹侧表面的压力梯度比大脑凸面的压力梯度大6.6倍。压力梯度在统计上随着老化而没有变化。 iNPH患者的压力梯度是健康志愿者的3.2倍。 4D-PC MRI数据的定量分析表明，脑脊液压力梯度可以用来了解脑脊液环境，而解剖图像的主观印象不足以给出这一点。
Magnetic resonance imaging (MRI) can depict not only anatomical information, but also physiological factors such as velocity and pressure gradient. Measurement of these physiological factors is necessary to understand the cerebrospinal fluid (CSF) environment. In this study we quantified CSF motion in various parts of the CSF space, determined changes in the CSF environment with aging, and compared CSF pressure gradient between patients with idiopathic normal pressure hydrocephalus (iNPH) and healthy elderly volunteers. Fifty-seven healthy volunteers and six iNPH patients underwent four-dimensional (4D) phase-contrast (PC) MRI. CSF motion was observed and the pressure gradient of CSF was quantified in the CSF space. In healthy volunteers, inhomogeneous CSF motion was observed whereby the pressure gradient markedly increased in the center of the skull and gradually decreased in the periphery of the skull. For example, the pressure gradient at the ventral surface of the brainstem was 6.6 times greater than that at the convexity of the cerebrum. The pressure gradient was statistically unchanged with aging. The pressure gradient of patients with iNPH was 3.2 times greater than that of healthy volunteers. The quantitative analysis of 4D-PC MRI data revealed that the pressure gradient of CSF can be used to understand the CSF environment, which is not sufficiently given by subjective impression of the anatomical image.