目的：采用 M RI结合半自动软件全定量评估脑积水患者颅内脑脊液的分布特点。方法对交通性脑积水患者（A组，34例）、非交通性脑积水患者（B组，24例）以及正常志愿者（C组，30例）分别于MRI上采用三维扰相自旋回波（SPACE）序列矢状位扫描，然后通过半自动软件计算枕骨大孔以上总脑脊液、脑室脑脊液、蛛网膜下腔脑脊液体积以及脑室占总脑脊液或蛛网膜下腔脑脊液的体积比。通过脑脊液三维容积成像，将侧脑室前部额叶、侧脑室体部额顶叶、侧脑室后方枕叶蛛网膜下腔脑脊液的狭窄程度按照4级分类法分级。结果 C组侧脑室后方枕叶蛛网膜下腔较窄， A组侧脑室体部额顶叶蛛网膜下腔变窄较明显，B组则全部蛛网膜下腔变窄。A组和B组总脑脊液、脑室脑脊液、蛛网膜下腔脑脊液体积以及脑室与蛛网膜下腔脑脊液或总脑脊液体积比均大于C组（P＜0．01）；而A组与B组间上述各观察指标亦有统计学差异（P＜0．01）。结论正常成人与不同类型脑积水患者侧脑室旁蛛网膜下腔脑脊液具有不同分布特点；通过评估脑脊液的分布及体积比例可以帮助诊断脑积水。%Objective To evaluate the volume and distribution of intracranial cerebrospinal fluid (CSF) with MRI and semiautomatic software in the patients with hydrocephalus .Methods The sagittal scanning with SPACE sequence at 3.0T MRI was performed in 34 patients with communicating hydrocephalus (group A ) ,24 patients with non-communicating hydrocephalus (group B) and 30 healthy people(group C) .Then the volumes of total ,ventricular and subarachnoid CSF were calculated with semiautomatic software .The volume ratio of ventricular CSF to total or subarachnoid CSF was calculated as well .According to 3D volume rendering of CSF ,the stenosis degree of subarachnoid CSF at prefrontal lobe ,high midline convexity and occipital lobe of the lateral ventricle was graded by four-level classification .Results The narrowed CSF space was found at occipital lobe in group C ,high midline convexity in group A and whole lateral ventricle in group B .The volumes of total ,ventricular and subarachnoid CSF and the volume ratio of ventricular CSF to total or subarachnoid CSF in groups of A and B were higher than those in group C (P<0 .01) ,while there was a statistical difference in each index above between groups of A and B (P<0 .01) .Conclusion The volume and distribution of intracranial CSF are different among healthy people and the patients with various types of hydrocephalus .Understanding this may be helpful in the diagnosis of hydrocephalus .
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