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Cine Phase-Contrast MR Images Failed to Predict Clinical Outcome Following ETV

Published online by Cambridge University Press:  02 December 2014

Xiao Di ,
M. Ragab  and
Mark G. Luciano
Xiao Di*
Affiliation:
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
M. Ragab
Affiliation:
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
Mark G. Luciano
Affiliation:
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
*
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, S90, Cleveland, Ohio, 44195, USA
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Abstract

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Background:

To predict success of endoscopic third ventriculostomy (ETV) in patients with obstructive hydrocephalus, we evaluated pre- and post- operative phase-contrast cine magnetic resonance images (PC MRI) on cerebrospinal fluid (CSF), cine flow in basal cisterns around the brain stem, and cervical medullar junction (CMJ) retrospectively.

Methods:

The study involved 102 patients with mean age of 36.74±23.25, and F/M = 1.55. All patients had PC MRI taken both pre- and post-operatively. A dynamic MRI video of PC MRI was reviewed at sagittal, axial, and coronal sections to determine cistern flows around the brain stem and CMJ. For quantitative analysis, quadrants were divided around midbrain axially to evaluate interpeduncular, quadrageminal, and ambient cisterns of both sides using scores of 0 to 60. Pre- and post- pontine and CMJ flows were shown in sagittal view and scored 0 to 20, and lateral cerebellopontine cisterns of both sides were measured on coronal image and scored 0 to 20.

Results:

No significant difference in CSF flow was seen from three individual views and total cine score, or between ETV success and failure groups by multivariate analysis of variance. Kaplan-Meier Analysis and Spearman's Correlation Test produced no relationship between MRI cine flow scores and interval period after surgery to ETV failure.

Conclusion:

PC MRI cine flow failed to demonstrate significant differences between successful and failed ETV groups. This indicates in addition to achieving an adequate fenestration, CSF pathways beyond the basal cisterns around the brain stem and CMJ may play an essential role in achieving ETV success.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 5 , September 2009 , pp. 643 - 647
Copyright
Copyright © The Canadian Journal of Neurological 2009

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