DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING IN PATIENTS WITH POSSIBLE IDIOPATHIC NORMAL PRESSURE HYDROCEPHALUS BEFORE AND AFTER TAP TEST

概要

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Dilated ventricles in patients with idiopathic normal pressure hydrocephalus (INPH) may cause dysfunction of Periventricular white matter. However, the pathophysiological mechanism of INPH symptoms is not well understood. In this study, we investigated axonal water dynamics using diffusion tensor imaging (DTI) in 36 patients with possible INPH before and after cerebrospinal fluid (CSF) tap test. Nineteen cases were negative for tap test (negative group) and 17 cases were positive (positive group). Regional apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured with 1.5T magnetic resonance imaging system. ADC values were significantly decreased in the frontal periventricular region and the body of the corpus callosum of the positive group after tap test (P<0.05). FA values were significantly increased in the body of the corpus callosum of both group after tap test (P<0.05). These results suggest that water molecules at the extracellular space might be moved to intraventricular space by reduction of the CSF in the lateral ventricles after tap test, resulting in decreased ADC values in the periventricular regions. After tap test, compression against axonal fibers in the body of the corpus callosum might be relieved by reduction of the CSF in the lateral ventricles, resulting in increased FA values.
名古屋市立大学の論文
2010-02-01