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JOURNAL OF NEUROSURGICAL SCIENCES

Rivista di Neurochirurgia


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Journal of Neurosurgical Sciences 2017 Sep 04

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 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


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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

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Publication History

Article first published online: September 04, 2017
Manuscript accepted: July 26, 2017
Manuscript revised: July 24, 2017
Manuscript received: May 18, 2017

Per citare questo articolo

Stecco A, Cassarà A, Zuccalà A, Anoaica MB, Genovese E, Car PG, et al. Quantitative analysis of cerebrospinal fluid dynamics at phase contrast cine-MRI: predictivity of neurosurgical "Shunt" responsiveness in patients with idiopathic normal pressure hydrocephalus. J Neurosurg Sci 2017 Sep 04. DOI: 10.23736/S0390-5616.17.04092-9

Corresponding author e-mail

a.stecco@libero.it