[Experimental study on pathophysiology and treatment of congenital hydrocephalus evaluated by magnetic resonance imaging and magnetic resonance spectroscopy].
I. Experimental Study on Pathophysiology of Congenital Hydrocephalus It is well known that the major pathogenic mechanism of hydrocephalus is disturbance in cerebrospinal fluid (CSF) circulation. For this reason, many studies on hydrocephalus were intended from the viewpoint of CSF circulation both experimentally and clinically. However, few studies have yet been done on the correlation between the morphological changes and the changes in cerebral energy metabolism in hydrocephalus in vivo. So, in this study, the correlation between the morphological changes and the changes in cerebral energy metabolism in congenital hydrocephalic rats was evaluated experimentally. The morphological changes were estimated by using magnetic resonance imaging (MRI), and the longitudinal relaxation time (T1) of brain tissue at parietal area was also measured. The cerebral energy metabolism was evaluated by using 31P magnetic resonance spectroscopy (MRS) method, and cerebral phospholipid membrane metabolism was also evaluated by using 31P-MRS method. The region of interest (ROI) giving rise to the 31P spectra was placed at fore-brain and parietal area. The PCr/Pi ratio was used as the chosen indicator of cellular bioenergetic status. The PME/beta-ATP ratio and PDE/beta-ATP ratio were used as the chosen indicator of cerebral phospholipid membrane metabolism. The intracellular pH was also evaluated by using 31P-MRS method. Fifty congenital hydrocephalic rats of the HTX strain were used. The animals were divided into two groups--non-hydrocephalic group (n = 15) and hydrocephalic group (n = 35)--. The rats of hydrocephalic group were subdivided into three smaller groups according to the degree of hydrocephalus--mild (n = 15), moderate (n = 10) and severe (n = 10)--, which was estimated by using the cerebro-ventricular ratio (CVR) in coronal section of MRI. Experimental results were as follows: 1) The T1 values in rats of mild, moderate and severe hydrocephalic groups showed significant elongation in comparison with the value in non-hydrocephalic group (p less than 0.01), which indicated the expansion of interstitial edema in cerebral cortex. 2) The correlation between the T1 value and the CVR was evaluated and the correlation coefficient (r) was 0.932 which indicated high correlation. 3) The PCr/Pi ratios in rats of mild, moderate and severe hydrocephalic groups were decreased significantly in comparison with the value in non-hydrocephalic group (p less than 0.01), which demonstrated the disturbance of cerebral energy metabolism in congenital hydrocephalic rats. 4) The PCr/Pi ratio seemed to give the indicative data concerning the prognosis of congenital hydrocephalus.(ABSTRACT TRUNCATED AT 400 WORDS)
Minamikawa
J
J
Department of Neurosurgery, Faculty of Medicine, Kyoto University, Japan.
D000818:Animals; D001921:Brain / Q000378:metabolism; D006849:Hydrocephalus / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D051381:Rats; D011919:Rats, Inbred Strains