Abstract：
OBJECTIVE: The choroid plexus contains specialized ependymal cells responsible for CSF production. Recent studies have demonstrated volumetric and perfusion changes in the choroid plexus with age and neurodegenerative disorders, however, volumetric changes in the choroid plexus in low pressure states is not known. The purpose of this study is to evaluate volumetric differences in choroid plexus size in patients with spontaneous intracranial hypotension (SIH) resultant from spinal CSF leaks compared with healthy controls.
METHODS: This was a retrospective, institutional review board-approved study. Patients with MRI evidence of SIH and a spinal CSF leak diagnosed on myelography and subsequently confirmed at surgery were included in this study. All patients included in this study including age-matched healthy controls had a brain MRI performed on a either a 1.5 or 3T scanner with acquisition of 3D T1 postcontrast (eg, BRAVO, MPRAGE, etc). In all patients, the trigonum ventriculi volume, in the atria of the lateral ventricles, was contoured by using Visage-7 segmentation tools on the volumetric postcontrast T1 sequence. A basic 2-tailed t test was used to compare choroid plexus volumes between the 2 groups.
RESULTS: Thirty-four patients were included with 17 patients with SIH with spinal CSF leak and 17 healthy control patients who were age- and sex-matched. The mean age of patients was 45 years, standard deviation 14 years. The mean volume of the choroid plexus for patients with SIH with spinal CSF leak was 1.2 cm3 (standard deviation = 0.26) compared with 0.63 cm3 (standard deviation = 0.31) in the control group (P < .0001).
CONCLUSIONS: Results of this study demonstrate a higher choroid plexus volume in patients with SIH with spinal CSF leak compared with age- and sex-matched healthy controls. This likely reflects compensatory mechanisms to counteract intracranial hypotension by increasing CSF production as well as increased vascularity of the choroid plexus through expansion of the intracranial blood pool.
METHODS: This was a retrospective, institutional review board-approved study. Patients with MRI evidence of SIH and a spinal CSF leak diagnosed on myelography and subsequently confirmed at surgery were included in this study. All patients included in this study including age-matched healthy controls had a brain MRI performed on a either a 1.5 or 3T scanner with acquisition of 3D T1 postcontrast (eg, BRAVO, MPRAGE, etc). In all patients, the trigonum ventriculi volume, in the atria of the lateral ventricles, was contoured by using Visage-7 segmentation tools on the volumetric postcontrast T1 sequence. A basic 2-tailed t test was used to compare choroid plexus volumes between the 2 groups.
RESULTS: Thirty-four patients were included with 17 patients with SIH with spinal CSF leak and 17 healthy control patients who were age- and sex-matched. The mean age of patients was 45 years, standard deviation 14 years. The mean volume of the choroid plexus for patients with SIH with spinal CSF leak was 1.2 cm3 (standard deviation = 0.26) compared with 0.63 cm3 (standard deviation = 0.31) in the control group (P < .0001).
CONCLUSIONS: Results of this study demonstrate a higher choroid plexus volume in patients with SIH with spinal CSF leak compared with age- and sex-matched healthy controls. This likely reflects compensatory mechanisms to counteract intracranial hypotension by increasing CSF production as well as increased vascularity of the choroid plexus through expansion of the intracranial blood pool.
摘要：
目的：脉络丛含有专门的室管膜细胞，负责脑脊液的产生。最近的研究表明，随着年龄和神经退行性疾病，脉络丛的体积和灌注变化。然而,在低压状态下脉络丛的体积变化是未知的。这项研究的目的是评估与健康对照组相比，由脊髓CSF泄漏引起的自发性颅内低血压（SIH）患者的脉络丛大小的体积差异。
方法：这是一个回顾性研究，机构审查委员会批准的研究。本研究包括在脊髓造影上诊断为SIH和脊髓CSF渗漏的MRI证据并随后在手术中证实的患者。本研究中包括的所有患者，包括年龄匹配的健康对照，均在1.5或3T扫描仪上进行了脑部MRI，并采集了3DT1对比后（例如，布拉沃,MPRAGE,etc).在所有患者中，三角脑室容积,在侧脑室的心房，通过在体积对比后T1序列上使用Visage-7分割工具进行轮廓化。使用基本的2尾t检验比较两组之间的脉络丛体积。
结果：34例患者包括17例患有脊髓CSF漏的SIH患者和17例年龄和性别匹配的健康对照患者。病人的平均年龄是45岁,标准差14年。SIH伴脊髓脑脊液漏患者的脉络丛平均体积为1.2cm3（标准偏差=0.26），而对照组为0.63cm3（标准偏差=0.31）（P<0.0001）。
结论：这项研究的结果表明，与年龄和性别匹配的健康对照组相比，患有脊髓脑脊液漏的SIH患者的脉络丛体积更高。这可能反映了通过增加CSF的产生以及通过颅内血池的扩张增加脉络丛的血管形成来抵消颅内低血压的代偿机制。
方法：这是一个回顾性研究，机构审查委员会批准的研究。本研究包括在脊髓造影上诊断为SIH和脊髓CSF渗漏的MRI证据并随后在手术中证实的患者。本研究中包括的所有患者，包括年龄匹配的健康对照，均在1.5或3T扫描仪上进行了脑部MRI，并采集了3DT1对比后（例如，布拉沃,MPRAGE,etc).在所有患者中，三角脑室容积,在侧脑室的心房，通过在体积对比后T1序列上使用Visage-7分割工具进行轮廓化。使用基本的2尾t检验比较两组之间的脉络丛体积。
结果：34例患者包括17例患有脊髓CSF漏的SIH患者和17例年龄和性别匹配的健康对照患者。病人的平均年龄是45岁,标准差14年。SIH伴脊髓脑脊液漏患者的脉络丛平均体积为1.2cm3（标准偏差=0.26），而对照组为0.63cm3（标准偏差=0.31）（P<0.0001）。
结论：这项研究的结果表明，与年龄和性别匹配的健康对照组相比，患有脊髓脑脊液漏的SIH患者的脉络丛体积更高。这可能反映了通过增加CSF的产生以及通过颅内血池的扩张增加脉络丛的血管形成来抵消颅内低血压的代偿机制。
