Home > Journals > Journal of Neurosurgical Sciences > Past Issues > Articles online first > Journal of Neurosurgical Sciences 2017 Sep 04

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as

 

 

Journal of Neurosurgical Sciences 2017 Sep 04

DOI: 10.23736/S0390-5616.17.04092-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Quantitative analysis of cerebrospinal fluid dynamics at phase contrast cine-MRI: predictivity of neurosurgical "Shunt" responsiveness in patients with idiopathic normal pressure hydrocephalus

Alessandro STECCO 1 , Alessia CASSARÀ 1, Alberto ZUCCALÀ 1, Mihaela B. ANOAICA 1, Egidio GENOVESE 2, Pier G. CAR 3, Gabriele P. PANZARASA 3, Giuseppe GUZZARDI 1, Alessandro CARRIERO 1

1 Radiology Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Novara, Italy; 2 Consultant of Radiology Department "Maggiore della Carità" Hospital, University of Eastern Piedmont, Novara, Italy; 3 Neurosurgery Department, "Maggiore della Carità" Hospital, University of Eastern Piedmont, Novara, Italy


PDF


BACKGROUND: Aqueductal stroke volume (ACSV) measured by phase-contrast cine (PCC)-MRI has been proposed with controversy as a tool for the selection of patients with normal pressure hydrocephalus (NPH) as candidates for shunt-surgery. The aim of this study was to assess if PCC-MRI scan measurements of ACSV could select properly these patients.
METHODS: We retrospectively reviewed charts and MRI of 38 shunted patients (72,16 ±6,16 years). ACSV measurements were performed 7-30 days before shunt and at the first and sixth months after surgery. Normally distributed variables were compared in the two groups (improved/unimproved) by T-test for baseline values and with repeated measures analysis of variance.
RESULTS: 26 patients (68,4 %) improved after VPS (mean time of symptom onset was 8,15 ±7,19 months). Mean preoperative ACSV value was 271,85 ± 143,03, which decreased by 21,6 % (mean 213 ± 125,14 ) at the first month and 40,3% sixth months after VPS (mean 162,15 ± 91,5). 12 patients (31,6 %) did not improve (mean time of symptom onset was 29 ± 5,62 months). Mean preoperative ACSV value was 79,83 ± 31,24, decreased to 8,7 % (mean 72,83 ±28,66 ) at first month after VPS, 21,2% (mean 62,83 ± 31,12 ) after six months. We found statistical difference between preoperative ACSV of improved and unimproved patients (p<0,01), onset time of symptoms (p<0,01) and the changes in ACSV after one and six months in both groups (p<0,001).
CONCLUSIONS: ACSV is useful to stratify patients with NPH after surgery (improved /not improved) suggesting to proceed with serial ACSV measurements before deciding treatment.


KEY WORDS: CSF flow - Aqueductal stroke volume - Normal-pressure hydrocephalus (NPH) - Phase-contrast MRI

top of page