Changes in Apparent Diffusion Coefficient (ADC) during Cardiac Cycle of the Brain in Idiopathic Normal Pressure Hydrocephalus Before and After Cerebrospinal Fluid Drainage
Changes in Apparent Diffusion Coefficient (ADC) during Cardiac Cycle of the Brain in Idiopathic Normal Pressure Hydrocephalus Before and After Cerebrospinal Fluid Drainage
复制标题
DOI：
10.1002/jmri.27412
复制
发表时间：
2020-10-28
影响因子：
4.4
通讯作者：
Gabata, Toshifumi
中科院分区：
文献类型：
--
作者：
Osawa, Tomoshi;Ohno, Naoki;Gabata, Toshifumi
背景特发性常压性脑积水(INPH)症状的发病机制目前尚不清楚。目的观察腰椎抽液分流术前后脑表观弥散系数(ADC)在心动周期(Delta ADC)中的动态变化，以确定脑脊液引流治疗INPH后脑内流体动力学和生物力学性质的变化。阳性组7例于分流术后1周至1个月行场强/序列1.5T、心电图同步单次激发扩散回波平面成像，比较术前、术后24小时、术后1周至1个月的额叶白质Delta ADC和平均ADC(Mean)，统计学检验采用Wilcoxon符号等级检验。结果阳性组治疗后Delta ADC明显低于治疗前(P<；0.05)，阴性组差异无统计学意义(P=0.23)。17例阳性患者中，16例在腰椎抽吸治疗后，Delta ADC下降，而ADC均值无明显变化(P=0.96)。分流术后7例患者的Delta ADC均下降(P<0.05)，ADC均值无明显变化(P=0.87)。Delta ADC分析可以提供有关脑脊液引流过程中流体动力学和生物力学特性变化的详细信息。证据水平4.技术疗效阶段4。
Background The causative mechanisms of idiopathic normal-pressure hydrocephalus (iNPH) symptoms are currently unknown.Purpose To assess the dynamic changes in the apparent diffusion coefficient (ADC) during the cardiac cycle (Delta ADC) of the brain before and after the lumbar tap and shunt surgery for the purpose of determining changes in hydrodynamic and biomechanical properties in the brain after cerebrospinal fluid (CSF) drainage for iNPH.Study Type Retrospective.Subjects Overall, 22 patients suspected to have iNPH were examined before and after the lumbar tap and were divided into patients who showed symptomatic improvements (positive group, n = 17) and those without improvement (negative group, n = 5) after the lumbar tap. Seven patients in the positive group were examined after the shunt surgery.Field Strength/Sequence 1.5T, electrocardiographically synchronized single-shot diffusion echo-planar imaging.Assessment The frontal white matter Delta ADC and mean ADC (ADC(mean)) were compared between before and 24 hours after lumbar tap and from 1 week to 1 month after the shunt surgery.Statistical Tests Wilcoxon signed-rank test was used. P < 0.05 was considered statistically significant.Results The Delta ADC after the lumbar tap in the positive group was significantly lower than that before (P < 0.05), whereas no significant difference was found in the negative group (P = 0.23). After the lumbar tap, Delta ADC decreased in 16 of 17 patients in the positive group, whereas ADC(mean) did not significantly change (P = 0.96). After the shunt surgery, Delta ADC decreased in all seven patients (P < 0.05), whereas ADC(mean) did not significantly change (P = 0.87).Data Conclusion The frontal white matter Delta ADC in iNPH decreased after the lumbar tap and shunt surgery. Delta ADC analysis may provide detailed information regarding changes in the hydrodynamic and biomechanical properties through CSF drainage.Level of Evidence 4.Technical Efficacy Stage 4.