title: Agreement between CSF flow dynamics in MRI and ICP monitoring in the diagnosis of normal pressure hydrocephalus. Sensitivity and specificity of CSF dynamics to predict outcome.
abstract: OBJECTIVE
  The aims of the study were 1) to assess the degree of agreement between CSF flow dynamics determined by MR and ICP monitoring in the diagnosis of NPH, and 2) to determine the sensitivity and specificity of CSF flow dynamics studied by MR in predicting improvement after shunting.
  
  
  METHODS
  A prospective study was carried out in 35 consecutive patients with suspected NPH. CSF velocity (Phase Contrast) through the aqueduct was determined in sagittal plane. Patients were classified as "normal" or hyperdynamic in comparison with a control group of 27 healthy volunteers. Continuous extradural ICP monitoring was performed for at least 72 hours and patients were classified as having active, compensated, or ex-vacuo hydrocephalus. Patients with active or compensated hydrocephalus were shunted.
  
  
  RESULTS
  The degree of agreement between MR dynamics and ICP monitoring was 82%. Sensitivity of CSF velocity was 90% and specificity was 50%.
  
  
  CONCLUSIONS
  The degree of agreement between ICP monitoring and CSF velocity is high. High CSF velocity through the aqueduct is a good predictor of improvement after surgery. However, patients with normal velocity in MR required additional tests before a diagnosis of NPH is ruled out.
authors.affiliation: Department of Neurosurgery, Vall d'Hebron University Hospitals, Barcelona, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Poca
authors.forename: J
authors.initials: J
authors.lastname: Sahuquillo
authors.forename: M
authors.initials: M
authors.lastname: Busto
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: J
authors.initials: J
authors.lastname: Capellades
authors.forename: M
authors.initials: M
authors.lastname: Mataró
authors.forename: E
authors.initials: E
authors.lastname: Rubio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D007427:Intracranial Pressure / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009069:Movement Disorders / Q000209:etiology; D012016:Reference Values; D012680:Sensitivity and Specificity; D014549:Urinary Incontinence / Q000209:etiology