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Child's Nervous System

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01-11-2018 | Original Paper

Phase-contrast and three-dimensional driven equilibrium (3D-DRIVE) sequences in the assessment of paediatric obstructive hydrocephalus

Authors: Shaimaa Abdelsattar Mohammad, Noha Mohamed Osman, Reham M. Khalil

Published in: Child's Nervous System | Issue 11/2018

Abstract

Background

Recently, most cases of hydrocephalus are related to obstruction. Accurate localization of the site of obstruction is crucial in determination of the treatment strategy.

Purpose

To describe the phase-contrast and 3D-DRIVE findings in cases of obstructive hydrocephalus in paediatric patients and to determine their functional and anatomical correlates.

Material and methods

Brain MRIs of 25 patients (2 months to 11 years) with obstructive hydrocephalus were retrospectively reviewed. Phase-contrast and 3D-DRIVE were performed to assess cerebrospinal (CSF) pathways through the aqueduct of Sylvius and subarachnoid spaces. In addition to flow velocity measurement at the aqueduct of Sylvius, functional and anatomical correlation was analysed at the level of aqueduct of Sylvius, infracerebellar CSF space and at the third ventriculostomy using Spearman’s rank test.

Results

Aqueduct of Sylvius was the most common site of obstruction (19 patients) either secondary to focal, multifocal or tubular stenosis, adhesions, or secondary to extrinsic compression. Functional and anatomical correlation was analysed in 58 regions revealing strong correlation (ro = 0.8, p < .001). Functional anatomical mismatch was found in nine regions. Flow velocity measurements revealed diminished flow in most of the cases with obstruction at the aqueduct and normal velocity in cases with obstruction proximal to aqueductal level, while accelerated flow was seen in cases with infra-aqeuductal obstruction.

Conclusion

Phase-contrast and 3D-DRIVE sequences are essential sequences in the diagnosis of hydrocephalus enabling perfect localization of the site of obstruction. Both sequences should be interpreted in conjunction to avoid false results. Velocity measurements through the aqueduct can help understand CSF hydrodynamics.

Raybaud C (2016) MR assessment of pediatric hydrocephalus: a road map. Childs Nerv Syst 32:19–41CrossRef

Symss NP, Oi S (2013) Theories of cerebrospinal fluid dynamics and hydrocephalus: historical trend. J Neurosurg Pediatr 11:170–177CrossRef

Rekate HL (2011) A consensus on the classification of hydrocephalus: its utility in the assessment of abnormalities of cerebrospinal fluid dynamics. Childs Nerv Syst 27:1535–1541CrossRef

Algin O, Ozmen E, Karaoglanoglu M (2012) The role of MRI in pediatric obstructive hydrocephalus: an update. J Pediatr Neuroradiol 2:71–80

Cinalli G, Spennato P, Nastro A, Aliberti F, Trischitta V, Ruggiero C, Mirone G, Cianciulli E (2011) Hydrocephalus in aqueductal stenosis. Childs Nerv Syst 27:1621–1642CrossRef

Schroeder HW, Oertel J, Gaab MR (2004) Endoscopic aqueductoplasty in the treatment of aqueductal stenosis. Childs Nerv Syst 20:821–827CrossRef

Fritsch MJ, Schroeder HWS (2013) Endoscopic aqueductoplasty and stenting. World Neurosurg 79:S20.e15–S20.e18CrossRef

Kartal MG, Algin O (2014) Evaluation of hydrocephalus and other cerebrospinal fluid disorders with MRI: an update. Insights into Imaging 5:531–541CrossRef

Segev Y, Metser U, Beni-Adani L (2001) Morphometric study of the midsagittal MR imaging plane in cases of hydrocephalus and atrophy and in normal brains. Am J Neuroradiol 22:1674–1679PubMed

10.

Pople IK (2002) Hydrocephalus and shunts: what the neurologist should know. J Neurol Neurosurg Psychiatry 73:i17–i22CrossRef

11.

Battal B, Kocaoglu M, Bulakbasi N, Husmen G, Tuba Sanal H, Tayfun C (2011) Cerebrospinal fluid flow imaging by using phase-contrast MR technique. Br J Radiol 84:758–765CrossRef

12.

Bradley WG Jr (2015) CSF flow in the brain in the context of normal pressure hydrocephalus. Am J Neuroradiol 36:831–838CrossRef

13.

Yamada S, Tsuchiya K, Bradley WG, Law M, Winkler ML, Borzage MT, Miyazaki M, Kelly EJ, McComb JG (2015) Current and emerging MR imaging techniques for the diagnosis and management of CSF flow disorders: a review of phase-contrast and time-spatial labeling inversion pulse. Am J Neuroradiol 36:623–630CrossRef

14.

Dinçer A1, Kohan S, Ozek MM (2009) Is all “communicating” hydrocephalus really communicating? Prospective study on the value of 3D-constructive interference in steady state sequence at 3T. Am J Neuroradiol 30:1898–1906CrossRef

15.

McCoy MR, Klausner F, Weymayr F et al (2013) Aqueductal flow of cerebrospinal fluid (CSF) and anatomical configuration of the cerebral aqueduct (AC) in patients with communicating hydrocephalus—the trumpet sign. Eur J Radiol 82:664–670CrossRef

16.

Stoquart-El Sankari S, Lehmann P, Gondry-Jouet C et al (2009) Phase-contrast MR imaging support for the diagnosis of aqueductal stenosis. Am J Neuroradiol 30:209–214CrossRef

17.

Algin O, Hakyemez B, Parlak M (2010) Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography on the evaluation of the aqueductal stenosis. Neuroradiology 52:99–108CrossRef

18.

Park JH, Kim E, Park JP et al (2015) Utility of two types of MR cisternography for patency evaluation of aqueduct and third ventriculostomy site: three dimensional sagittal fast spin echo sequence and steady-state coherent fast gradient echo sequence. J Korean Soc Radiol 73:26–35CrossRef

19.

Fukuhara T, Vorster SJ, Ruggieri P, Luciano MG (1999) Third ventriculostomy patency: comparison of findings at cine phase-contrast MR imaging and at direct exploration. Am J Neuroradiol 20:1560–1566PubMed

20.

Raybaud A, Barkovich AJ (2012) Hydrocephalus. In: Barkovich AJ, Raybaud C (eds) Pediatric neuroimaging, 5th edn. Lippincott Williams & Wilkins, Philadelphia, pp 808–857

21.

Öztürk M, Sığırcı A, Ünlü S (2016) Evaluation of aqueductal cerebrospinal fluid flow dynamics with phase-contrast cine magnetic resonance imaging in normal pediatric cases. Clin Imaging 40:1286–1290CrossRef

22.

Rekate HL (2008) The definition and classification of hydrocephalus: a personal recommendation to stimulate debate. Cerebrospinal Fluid Res 5:2CrossRef

23.

Elkafrawy F, Reda I, Elsirafy M, Gawad MSA, Elnaggar A, Khalek Abdel Razek AA (2017) Three-dimensional constructive interference in steady state sequences and phase-contrast magnetic resonance imaging of arrested hydrocephalus. World Neurosurg 98:296–302CrossRef

24.

Kemp SS, Zimmerman RA, Bilaniuk LT et al (1987) Magnetic resonance imaging of the cerebral aqueduct. Neuroradiology 29:430–436CrossRef

25.

Fukuhara T, Luciano MG (2001) Clinical features of late-onset idiopathic aqueductal stenosis. Surg Neurol 55:132–136CrossRef

26.

Schroeder HWS, Schweim C, Schweim KH, Gaab MR (2000) Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging. Neurosurg Focus 9:1–8CrossRef

27.

Stadlbauer A, Salomonowitz E, Brenneis C, Ungersböck K, van der Riet W, Buchfelder M, Ganslandt O (2012) Magnetic resonance velocity mapping of 3D cerebrospinal fluid flow dynamics in hydrocephalus: preliminary results. Eur Radiol 22:232–242CrossRef

28.

Brandner S, Buchfelder M, Eyuepoglu IY, Luecking H, Doerfler A, Stadlbauer A (2018) Visualization of CSF flow with time-resolved 3D MR velocity mapping in aqueductal stenosis before and after endoscopic third ventriculostomy: a feasibility study. Clin Neuroradiol 28(1):69–74CrossRef

29.

Brandner S, Buchfelder M, Eyuepoglu IY, Luecking H, Doerfler A, Stadlbauer A (2016) Visualization of CSF flow with time-resolved 3D MR velocity mapping in aqueductal stenosis before and after endoscopic third ventriculostomy: a feasibility study. Clin Neuroradiol 28(1):69–74. https://doi.org/10.1007/s00062-016-0530-3 CrossRef

30.

Kadowaki C, Hara M, Numoto M, Takeuchi K, Saito I (1995) Cine magnetic resonance imaging of aqueductal stenosis. Childs Nerv Syst 11:107–111CrossRef

31.

Yildiz H, Yazici Z, Hakyemez B et al (2006) Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging. Neuroradiology 48:595–605CrossRef

32.

Laitt RD, Mallucci CL, Jaspan T, McConachie NS, Vloeberghs M, Punt J (1999) Constructive interference in steady-state 3D Fourier-transform MRI in the management of hydrocephalus and third ventriculostomy. Neuroradiology 41(2):117–123CrossRef

Title: Phase-contrast and three-dimensional driven equilibrium (3D-DRIVE) sequences in the assessment of paediatric obstructive hydrocephalus
Authors: Shaimaa Abdelsattar Mohammad
Noha Mohamed Osman
Reham M. Khalil
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 11/2018
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-018-3850-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Phase-contrast and three-dimensional driven equilibrium (3D-DRIVE) sequences in the assessment of paediatric obstructive hydrocephalus

Abstract

Background

Purpose

Material and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Material and methods

Results

Conclusion

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