脑脊液流动动力学和体积变化与乙状窦壁破裂-搏动性耳鸣伴特发性颅内高压有关。

IF 2.1 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Magnetic resonance imaging Pub Date : 2024-12-21 DOI:10.1016/j.mri.2024.110315

Lanyue Chen , Wei Li , Xiaobo Ma , Xiaoxia Qu , Dandan Zheng , Zhaohui Liu

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引用次数: 0

摘要

目的：探讨乙状窦壁裂（ssvd）并发颅内高压的脉动性耳鸣（PT）患者脑脊液（CSF）的血流动力学和容量变化。方法：35例伴有颅内高压的SSWD-PT患者和35名年龄、性别和手性相匹配的健康志愿者进行前瞻性研究，并进行MRI检查。收集临床资料。采用相对比磁共振成像（PC-MRI）评估脑脊液流动动力学，使用ITK-SNAP软件测量脑脊液体积。结果：与对照组相比，PT患者的身体质量指数（BMI）显著升高（P = 0.046）。在脑脊液血流动力学方面，PT患者的平均流量（MF）（P = 0.017）、平均流速（MV）（P = 0.038）、峰值流速（PV）（P = 0.023）显著低于对照组，反流分数（RF）（P = 0.010）显著高于对照组。两组间其他脑脊液流动动力学参数无显著差异。PT患者脑脊液体积明显高于对照组（P = 0.024）。射频和脑脊液体积有潜在的诊断价值。RF和CSF体积的AUC、敏感性、特异性和准确性分别为0.678、68.6 %、60.0 %、61.4 %和0.656、68.6 %、57.1 %、55.7 %。RF和CSF体积联合诊断效率最高，AUC、敏感性、特异性和准确性分别为0.733、74.3 %、62.9 %、67.1 %。结论：SSWD-PT患者存在脑脊液血流动力学和体积变化，这可能与PT的发生有关，除结构异常外，RF与脑脊液体积的结合可创新作为识别SSWD作为PT准确病因的补充指标。

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Cerebrospinal fluid flow dynamics and volume changes are related with sigmoid sinus wall dehiscence-pulsatile tinnitus with idiopathic intracranial hypertension

Purpose

To evaluate cerebrospinal fluid (CSF) flow dynamics and volume changes of pulsatile tinnitus (PT) patients induced by sigmoid sinus wall dehiscence (SSWD) with intracranial hypertension.

Methods

Thirty-five SSWD-PT patients coexisted with intracranial hypertension and 35, age-, gender-, and handedness-matched healthy volunteers were prospectively enrolled and performed MRI. Clinical data were collected. CSF flow dynamics were evaluated by phase-contrast magnetic resonance imaging (PC-MRI) and CSF volume was measured using ITK-SNAP software.

Results

Compared with controls, the body mass index (BMI) of PT patients increased significantly (P = 0.046). Among CSF flow dynamics, PT patients presented significantly decreased mean flux (MF) (P = 0.017), mean velocity (MV) (P = 0.038), peak velocity (PV) (P = 0.023), and significantly increased regurgitant fraction (RF) (P = 0.010) than controls. There were no significant differences in other CSF flow dynamics parameters between the groups. CSF volume of PT patients was significantly increased than controls (P = 0.024). RF and CSF volume had potential diagnostic value. The AUC, sensitivity, specificity and accuracy of RF and CSF volume were 0.678, 68.6 %, 60.0 %, 61.4 % and 0.656, 68.6 %, 57.1 %, 55.7 %, respectively. The combined diagnostic efficacy of RF and CSF volume was highest, and the AUC, sensitivity, specificity and accuracy were 0.733, 74.3 %, 62.9 %, 67.1 % respectively.

Conclusion

SSWD-PT patients present CSF flow dynamics and volume changes, which may be related to the occurrence of PT. In addition to structural abnormalities, the combination of RF and CSF volume can be innovative as a complementary index to identify SSWD as the accurate etiology of PT.

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来源期刊

Magnetic resonance imaging 医学-核医学

CiteScore

4.70

自引率

4.00%

发文量

194

审稿时长

83 days

期刊介绍： Magnetic Resonance Imaging (MRI) is the first international multidisciplinary journal encompassing physical, life, and clinical science investigations as they relate to the development and use of magnetic resonance imaging. MRI is dedicated to both basic research, technological innovation and applications, providing a single forum for communication among radiologists, physicists, chemists, biochemists, biologists, engineers, internists, pathologists, physiologists, computer scientists, and mathematicians.