1.陕西省核工业二一五医院 脑神经重症医学科;2.咸阳市脑神经功能研究重点实验室
- xieguoqiang 1,2
- xueqian xiao 1
- dongfei wu 1
- jingku ma 1
- hui zhang 1
- an wei 1
- yongqiang zhao 1
- hongfei wang 1
Nuclear Industry 215 Hospital of Shaanxi Province
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目的 探讨分析磁共振平扫与3D FIESTA序列在脑积水内镜下三脑室底造瘘术后早期疗效评估的应用价值。方法 回顾性分析陕西省核工业二一五医院2020年1月至2023年12月收治的脑室镜下三脑室底造瘘术17例症状性脑积水患者临床资料,术前及术后早期(1月内)常规行磁共振平扫(T1WI、T2WI、Flair序列)及3D FIESTA序列检查,分别根据依据手术前后脑室系统大小变化(Evans指数)、脑室周围间质水肿程度及三脑室底部和终板结构移位等指标将病例分为治疗有效组和治疗无效组。结果 早期磁共振平扫显示脑积水脑治疗有效组7例(41.2%)、治疗无效组10例(58.8%)；3D FIESTA序列扫描显示治疗有效组15例(88.2%),治疗无效组(11.8%)例,二者在梗阻性脑积水行三脑室底造瘘术后早期评估方面有显著性差异(P=0.010)。结论 磁共振3D FIESTA序列检查可以为梗阻性脑积水的三脑室底造瘘术后早期疗效评估提供客观精准影像指导。
Objective To evaluate the value of routine magnetic resonance (MR) scanning and 3D FIESTA sequence in the early prognosis of the endoscopic third ventriculostomy. Methods The clinical materials of 17 cases of obstructive hydrocephalus treated with endoscopic third ventriculostomy (ETV) in the Nuclear Industry 215 Hospital of Shaanxi Province between January 2020 and December 2023 were analyzed retrospectively. Preoperative and early postoperative (within 1-month) routine MR imaging (T1WI, T2WI, Flair) and 3D FIESTA imaging were performed simultaneously. The patients were divided into improved group and unchanged group according to the size change of the ventricular system (Evans index), the degree of periventricular interstitial edema and the displacement of the bottom and endplate of the third ventricle. Results Early postoperative routine MR scan showed that the hydrocephalus was improved in 7 cases (41.2%)and unchanged in 10 cases(58.8%). While the 3D FIESTA imaging revealed that there were 15 cases (88.2%) in approved group and 2 cases (11.2%) in unchanged group. There were significant differences between routine MR imaging and 3D FIEATS imaging in the early prognostic evaluation of obstructive hydrocephalus (P=0.010). Conclusion Perioperative MR imaging and 3D FIESTA sequence can provide early, objective and accurate imaging guidance for the diagnosis, differential diagnosis and postoperative evaluation of obstructive hydrocephalus.
