Spinal CSF flow in response to forced thoracic and abdominal respiration
Spinal CSF flow in response to forced thoracic and abdominal respiration
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DOI：
10.1186/s12987-019-0130-0
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发表时间：
2019-04-04
影响因子：
7.3
通讯作者：
Dreha-Kulaczewski, Steffi
中科院分区：
文献类型：
--
作者：
Aktas, Goekmen;Kollmeier, Jost M.;Dreha-Kulaczewski, Steffi
背景资料：呼吸诱导的压力变化代表了CSF动力学的强大驱动力，如先前使用流量敏感的实时磁共振成像（MRI）所证明的。本研究的目的是阐明脑脊液流量沿着椎管的敏感性，以强迫胸部与腹部breathing.Methods：18例没有已知的疾病进行了研究，使用实时相衬流MRI在3 T的导水管和沿着椎管水平C3，Th1，Th8和L3。受试者进行了一个协议，包括四个周期的2.5秒吸气和2.5秒expiration.Results：脊髓脑脊液流量和体积的定量结果证实了先前的研究结果，在强制吸气和反向向下流动，在随后的呼气两种呼吸类型的向上运动。然而，腹式呼吸的影响比胸式呼吸更明显，特别是在脊髓水平Th8和L3。在一般情况下，CSF净流量是非常相似的两个呼吸条件指向向上在所有location.Conclusions：脊髓CSF动态变化的呼吸性能是敏感的。响应于深胸呼吸与腹式呼吸的不同CSF流量分别反映了胸内和腹腔内压力的瞬时调整。根据定义的呼吸模式实时MRI访问CSF流量对于脑积水、假性脑瘤等CSF循环紊乱的患者具有临床重要性。
Background: Respiration-induced pressure changes represent a powerful driving force of CSF dynamics as previously demonstrated using flow-sensitive real-time magnetic resonance imaging (MRI). The purpose of the present study was to elucidate the sensitivity of CSF flow along the spinal canal to forced thoracic versus abdominal respiration.Methods: Eighteen subjects without known illness were studied using real-time phase-contrast flow MRI at 3 T in the aqueduct and along the spinal canal at levels C3, Th1, Th8 and L3. Subjects performed a protocol of forced breathing comprising four cycles of 2.5 s inspiration and 2.5 s expiration.Results: The quantitative results for spinal CSF flow rates and volumes confirm previous findings of an upward movement during forced inspiration and reversed downward flow during subsequent exhalation-for both breathing types. However, the effects were more pronounced for abdominal than for thoracic breathing, in particular at spinal levels Th8 and L3. In general, CSF net flow volumes were very similar for both breathing conditions pointing upwards in all locations.Conclusions: Spinal CSF dynamics are sensitive to varying respiratory performances. The different CSF flow volumes in response to deep thoracic versus abdominal breathing reflect instantaneous adjustments of intrathoracic and intraabdominal pressure, respectively. Real-time MRI access to CSF flow in response to defined respiration patterns will be of clinical importance for patients with disturbed CSF circulation like hydrocephalus, pseudotumor cerebri and others.