磁共振脑脊液电影对四脑室囊虫病诊断意义的研究

目的：探讨磁共振脑脊液电影对四脑室囊虫病的诊断意义。材料与方法：经手术病理证实的四脑室囊虫病９例，回顾性分析其磁共振脑脊液电影表现。脑脊液电影采用头部正中矢状面，手指门控扫描技术。结果：（１）直接显示脑脊液（ＣＳＦ）循环通路及分布情况，四脑室内病灶均表现为ＣＳＦ的充盈缺损区。囊虫均为囊性，信号均、壁光整，壁可薄可厚。（２）ＣＳＦ流动为搏动性往复运动，以导水管区最明显。在心脏收缩期，导水管内的ＣＳＦ由三脑室流向四脑室，囊虫上方残余的四脑室腔扩张增大，舒张期缩小，顺应性良好。（３）四脑室囊虫存活期，边缘光整，ＣＳＦ于其上方前后分流呈杯口状，囊虫游离于四脑室内，并可滚动，其形态在一个心动周期内可有轻微变化；退变死亡期囊虫，周围室管膜出现炎性反应，并与囊虫壁粘连，ＣＳＦ循环受阻更明显。结论：磁共振不但能对四脑室囊虫病做出准确的定位、定性诊断，而且可通过脑脊液电影了解囊虫灶对ＣＳＦ循环的阻塞程度和方式，以及观察囊虫与室管膜是否有粘连，从而为选择治疗方案提供指导意义。

Study of cysticercosis in the fourth ventricle by CSF cine MRI

Purpose: To evaluate the diagnostic value of cysticercosis in the fourth ventricle by CSF cine MRI. Materials and methods: Nine patients with intraventricular cysticercosis in the fourth ventricle were studied. The diagnosis was confirmed by surgery in all cases. All of these patients were examined systematically before the operation and studied with CSF cine MRI in midsagittal section and finger gated scan technique. Results :(1) The path of CSF flow was directly displayed. All cysticercosis presented as a filling defect, and a cyst with a smooth wall. (2) The ventricular compliance was normal in cysticercosis. (3) The cysticercosis in active stage was free in the fourth ventricle and could be rolled over, its shape might change slightly within a cardiac cycle. In the degenerative stage, its wall could adhere to the ependyma and obstruct the CSF flow. Conclusion: CSF cine MRI can demonstrate the degree of obstruction and pattern of CSF flow in cysticercosis of the fourth ventricle, thereby providing useful information for proper management.