MR imaging quantitative study of intracranial hypotension syndrome
10.3760/cma.j.issn.1671-8925.2015.05.017
- VernacularTitle:低颅压综合征的磁共振成像定量研究
- Author:
Weizhong TIAN
1
;
Ji ZHANG
;
Jinhua CHEN
;
Hongbin DING
;
Jianguo XIA
;
Ying LIU
Author Information
1. 225300,江苏省泰州市人民医院医学影像科
- Keywords:
Magnetic resonance imaging;
Intracranial hypotension;
Mamillopontine distance;
Pontomesencephalic angle
- From:
Chinese Journal of Neuromedicine
2015;14(5):511-515
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the MRI findings and the variability of quantitative indicators in intracranial hypotension syndrome (IHS) to yield a deeper understanding of the disease.Methods The clinical data and MR imaging findings of 26 patients with IHS confirmed by lumbar puncture during August 2006 to December 2013 in our hospital were retrospectively analyzed.Other 26 healthy volunteers matched with gender and age were recruited as control group.The MRI findings (dural thickening and enhancement,pituitary enlargement,subdural collections,venous engorgement and sagging brain) and quantitative assessments (mamillopontine distance and pontomesencephalic angle) were evaluated retrospectively by two doctors,the consistency between the two doctors was assessed by Kappa consistency test.The difference of mamillopontine distance and pontomesencephalic angle between patient group and control group was assessed by t test.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy and assure the optimal diagnostic threshold.Results There were excellent interobserver agreements for dural thickening and enhancement,pituitary enlargement,subdural collections,venous engorgement and the measurement of mamillopontine distance and pontomesencephalic angle (Kappa=l.000,0.846,1.000,0.906,0.919 and 0.808,P＜0.05).Sagging brain showed moderate agreement between readers (Kappa=0.606,P＜0.05).The mamillopontine distance (5.4±1.6 mm) and pontomesencephalic angle (47.8±8.7 °) in patient group were significantly lower than those of control group (6.9±1.1 mm and 61.0±6.1 °,P＜0.05).The area under ROC curve of mamillopontine distance and pontomesencephalic angle was 0.774 and 0.908,respectively,and the diagnostic value ofpontomesencephalic angle was higher than that of the mamillopontine distance.The sensitivity and specificity were 73.1％ and 73.1％,respectively,when mamillopontine distance was 6.4 mm.The sensitivity and specificity were 76.9％ and 96.2％,respectively,when pontomesencephalic angle was 51.7°.Conclusions The MR imaging findings present characteristic features of IHS.The quantitative indicators including mamillopontine distance and pontomesencephalic angle are helpful in clinical diagnosis of IHS.
