Measurement of CSF dynamics with oscillating pressure infusion

被引：8
作者：
Andersson, K. [1 ]
Manchester, I. R. [2 ]
Laurell, K. [3 ,4 ]
Cesarini, K. Giuliana [3 ]
Malm, J. [4 ]
Eklund, A. [1 ,5 ]
机构：
[1] Umea Univ, Dept Radiat Sci, S-90185 Umea, Sweden
[2] MIT, Comp Sci & Artificial Intelligence Lab, Cambridge, MA 02139 USA
[3] Univ Uppsala Hosp, Dept Neurosci, Uppsala, Sweden
[4] Umea Univ, Dept Clin Neurosci, S-90185 Umea, Sweden
[5] Umea Univ, Ctr Biomed Engn & Phys, S-90185 Umea, Sweden
来源：
ACTA NEUROLOGICA SCANDINAVICA | 2013年 / 128卷 / 01期
基金：
瑞典研究理事会;
关键词：
cerebrospinal fluid; hydrocephalus; normal pressure; intracranial pressure; CSF dynamics; outflow conductance;
D O I：
10.1111/ane.12063
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Introduction Infusion tests are used to diagnose and select patients with idiopathic normal pressure hydrocephalus (INPH) for shunt surgery. The test characterizes cerebrospinal fluid dynamics and estimates parameters of the cerebrospinal fluid system, the pressure-volume index (PVI) and the outflow conductance (Cout). The Oscillating Pressure Infusion (OPI) method was developed to improve the test and reduce the investigation time. The aim of this study was to evaluate the new OPI method by comparing it with an established reference method. Methods Forty-seven patients (age 71.2 +/- 8.9years) with communicating hydrocephalus underwent a preoperative lumbar infusion investigation with two consecutive infusion protocols, reference (42min) and new (20min), that is, 94 infusion tests in total. The OPI method estimated Cout and PVI simultaneously. A real-time analysis of reliability was applied to investigate the possibility of infusion time reduction. Results The difference in Cout between the methods was 1.2 +/- 1.8l/s/kPa (Rout=-0.8 +/- 3.5mmHg/ml/min), P<0.05, n=47. With the reliability analysis, the preset 20min of active infusion could have been even further reduced for 19 patients to between 10 and 19min. PVI was estimated to 16.1 +/- 6.9ml, n=47. Conclusions The novel Oscillating Pressure Infusion method produced real-time estimates of Cout including estimates of reliability that was in good agreement with the reference method and allows for a reduced and individualized investigation time.
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收藏
页码：17 / 23
页数：7
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