Abstract:
Pulsatile spinal cord and CSF velocities related to the cardiac cycle can be depicted by phase-contrast MRI. Among patients with spontaneous intracranial hypotension, we have recently described relevant differences compared with healthy controls in segment C2/C3. The method might be a promising tool to solve clinical and diagnostic ambiguities. Therefore, it is important to understand the physiological range and the effects of clinical and anatomical parameters in healthy volunteers. Within a prospective study, 3D T2-weighted MRI for spinal canal anatomy and cardiac-gated phase-contrast MRI adapted to CSF flow and spinal cord motion for time-resolved velocity data and derivatives were performed in 70 participants (age 20-79 years) in segments C2/C3 and C5/C6. Correlations were analyzed by multiple linear regression models; p < 0.01 was required to assume a significant impact of clinical or anatomical data quantified by the regression coefficient B. Data showed that in C2/C3, the CSF and spinal cord craniocaudal velocity ranges were 4.5 ± 0.9 and 0.55 ± 0.15 cm/s; the total displacements were 1.1 ± 0.3 and 0.07 ± 0.02 cm, respectively. The craniocaudal range of the CSF flow rate was 8.6 ± 2.4 mL/s; the CSF stroke volume was 2.1 ± 0.7 mL. In C5/C5, physiological narrowing of the spinal canal caused higher CSF velocity ranges and lower stroke volume (C5/C6 B = +1.64 cm/s, p < 0.001; B = -0.4 mL, p = 0.002, respectively). Aging correlated to lower spinal cord motion (e.g., B = -0.01 cm per 10 years of aging, p < 0.001). Increased diastolic blood pressure was associated with lower spinal cord motion and CSF flow parameters (e.g., C2/C3 CSF stroke volume B = -0.3 mL per 10 mmHg, p < 0.001). Males showed higher CSF flow and spinal cord motion (e.g., CSF stroke volume B = +0.5 mL, p < 0.001; total displacement spinal cord B = +0.016 cm, p = 0.002). We therefore propose to stratify data for age and sex and to adjust for diastolic blood pressure and segmental narrowing in future clinical studies.
摘要:
与心动周期相关的搏动脊髓和CSF速度可以通过相位对比MRI来描绘。在自发性低颅压患者中,我们最近描述了C2/C3段与健康对照组相比的相关差异.该方法可能是解决临床和诊断歧义的有希望的工具。因此,了解健康志愿者的生理范围以及临床和解剖参数的影响非常重要。在一项前瞻性研究中,在段C2/C3和段C5/C6的70名参与者(年龄20-79岁)中进行了用于椎管解剖的3DT2加权MRI和适用于CSF流量和脊髓运动的时间分辨速度数据和导数的心脏门控相位对比MRI。通过多元线性回归模型分析相关性;需要p<0.01才能假定由回归系数B量化的临床或解剖学数据的显着影响。数据显示,在C2/C3中,CSF和脊髓颅尾速度范围分别为4.5±0.9和0.55±0.15cm/s;总位移分别为1.1±0.3和0.07±0.02cm,分别。脑脊液流速的颅尾范围为8.6±2.4mL/s;脑脊液每搏量为2.1±0.7mL。在C5/C5中,椎管的生理狭窄导致更高的CSF速度范围和更低的每搏输出量(C5/C6B=1.64cm/s,p<0.001;B=-0.4mL,分别为p=0.002)。衰老与下脊髓运动相关(例如,B=每10年老化-0.01厘米,p<0.001)。舒张压升高与下脊髓运动和脑脊液流量参数相关(例如,C2/C3CSF每搏输出量B=-0.3mL/10mmHg,p<0.001)。男性表现出更高的脑脊液流量和脊髓运动(例如,CSF每搏量B=+0.5mL,p<0.001;总位移脊髓B=+0.016cm,p=0.002)。因此,我们建议对年龄和性别的数据进行分层,并在未来的临床研究中调整舒张压和节段狭窄。