Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography on the evaluation of the aqueductal stenosis.
BACKGROUND
In the current study, we aimed to compare the diagnostic efficacies of phase-contrast magnetic resonance imaging (PC-MRI) and three-dimensional constructive interference in steady-state (3D-CISS) sequence over detection of aqueductal stenosis (AS) on the basis of contrast-enhanced magnetic resonance cisternography (MRC).


METHODS
Twenty-five patients with clinically and radiologically suspected AS were examined by PC-MRI, 3D-CISS, and MRC. Axial-sagittal PC-MRI and sagittal 3D-CISS were applied to view the cerebral aqueduct. Following injection of 0.5-1 ml intrathecal gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) injection, postcontrast MRC images were obtained in three planes in early and late phases. Aqueductal patency was scored as follows: grade 0, normal; grade 1, partial narrowing; and grade 2, complete obstruction. Results of PC-MRI and 3D-CISS were compared with the findings of MRC.


RESULTS
In PC-MRI, seven cases were assessed as grade 0, 16 cases grade 1, and two cases grade 2. As a result of 3D-CISS sequence, eight cases were evaluated as grade 0, 12 cases grade 1, and five cases grade 2. Based on MRC, nine cases were assessed as grade 0, whereas nine and seven cases were evaluated to be grades 1 and 2, respectively. Five cases that demonstrated partial patency in PC-MRI or 3D-CISS showed complete obstruction by MRC.


CONCLUSIONS
PC-MRI is helpful in confirming the AS. However, positive flow does not necessarily exclude the existence of AS. 3D-CISS sequence provides excellent cerebrospinal fluid-to-aqueduct contrast, allowing detailed study of the anatomic features of the aqueduct. MRC should be performed on patients who demonstrate suspected AS findings on PC-MRI and/or 3D-CISS sequences.
Algin
Oktay
O
Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa, Turkey. droktayalgin@gmail.com
Hakyemez
Bahattin
B
Parlak
Mufit
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000473:pathology*; D002535:Cerebral Aqueduct / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
D003287:Contrast Media; D019786:Gadolinium DTPA