Home > Riviste > Journal of Neurosurgical Sciences > Fascicoli precedenti > Journal of Neurosurgical Sciences 2020 October;64(5) > Journal of Neurosurgical Sciences 2020 October;64(5):420-6

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi PROMO
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

ORIGINAL ARTICLE   

Journal of Neurosurgical Sciences 2020 October;64(5):420-6

DOI: 10.23736/S0390-5616.17.04092-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

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 1, Pier G. CAR 2, Gabriele P. PANZARASA 2, Giuseppe GUZZARDI 1, Alessandro CARRIERO 1

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



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: Twenty-six 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). Twelve 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: Stroke volume; Hydrocephalus, normal pressure; Magnetic resonance imaging

inizio pagina