Cervical compressive myelopathy: flow analysis of cerebrospinal fluid using phase-contrast magnetic resonance imaging

被引:19
作者
Bae, Yun Jung [1 ]
Lee, Joon Woo [1 ]
Lee, Eugene [1 ]
Yeom, Jin S. [2 ]
Kim, Ki-Jeong [3 ]
Kang, Heung Sik [1 ]
机构
[1] Seoul Natl Univ, Bundang Hosp, Coll Med, Dept Radiol, 166 Gumiro, Seongnam Si 463707, Gyeonggi Do, South Korea
[2] Seoul Natl Univ, Bundang Hosp, Coll Med, Dept Orthoped Surg, 166 Gumiro, Seongnam Si 463707, Gyeonggi Do, South Korea
[3] Seoul Natl Univ, Bundang Hosp, Coll Med, Dept Neurosurg, 166 Gumiro, Seongnam Si 463707, Gyeonggi Do, South Korea
基金
新加坡国家研究基金会;
关键词
Spinal cord; Spinal cord compression; Cerebrospinal fluid; Magnetic resonance imaging; cine; SPONDYLOTIC MYELOPATHY; SIGNAL INTENSITY; BLOOD-FLOW; CINE MR; SYSTEM; IMAGES; SPINE;
D O I
10.1007/s00586-016-4874-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
To evaluate cerebrospinal fluid (CSF) flow in cervical compressive myelopathy (CCM), by both quantitative and qualitative analyses, using 3T cine phase-contrast magnetic resonance imaging (cine MRI). From September, 2014 to June, 2015, we enrolled 45 subjects (18 women and 27 men, mean age, 61.7 +/- 13.4 years) to undergo cervical cine MRI. The subjects were divided into three groups: no stenosis and cervical stenosis with and without intramedullary T2 hyperintensity. We measured maximal CSF velocity, and 12 CSF velocity waveforms were plotted per subject. Two readers independently assessed the CSF waveform shape (0 absent; 1 serrated; 2 bi-directional with small amplitude; and 3 normal bi-directional waveform) and the CSF motion pattern (0 absent; 1 interrupted; and 2 intact). The numbers of 12 waveform shapes were summed to yield a CSF waveform score. Linear mixed model and ROC curve analyses were used for statistical analyses. Maximal CSF velocity was significantly lower in CCM (marginal mean, 2.72 cm/s) than in stenosis without intramedullary T2 hyperintensity (3.27 cm/s, p = 0.027) and no stenosis (3.80 cm/s, p < 0.001). Bi-phasic CSF motion was lost in cervical stenosis. CSF waveform scores of 17 (area under curve (AUC), 0.797; p = 0.003) and 16.5 (AUC, 0.790; p = 0.004) could predict Japanese Orthopedic Association (JOA) score corresponding to CCM. Maximal CSF velocity and CSF waveform score on cine MRI decreased in CCM and was correlated with the JOA score. Thus, both quantitative and qualitative analyses using cine MRI could effectively demonstrate CSF flow alterations in CCM.
引用
收藏
页码:40 / 48
页数:9
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