Comparison of computed tomography 3-dimensional volumetric analysis of ventricular size to visual radiological assessment.
OBJECTIVE
Interpretation of ventricular volume on computed tomography scans of hydrocephalus patients is usually subjective. The objective of this study was to determine whether radiological assessment of interval change correlates better with an objective calculated volume change or with other objective 2-dimensional estimates of ventricle volume change.


METHODS
Ventricular volume, Evans ratio, and frontal and occipital Horn ratio were retrospectively assessed on 95 pairs of scans from patients with a ventriculoperitoneal shunt. To determine ventricle volume, all voxels of cerebrospinal fluid density were isolated on a 3-dimensional reconstructed computed tomography scan. Voxels of fluid density contiguous with one another in the ventricular system were isolated. Radiological assessments of interval change were divided into 5 groups based on reported findings in the radiology report. The 95% mean confidence intervals were developed for changes in the measured parameters, given a particular radiological assessment. Multinomial regression was subsequently performed to determine which parameter was most closely correlated with the radiological assessment.


RESULTS
Significant overlap was found in the confidence intervals for objectively calculated volume change between the different categories of radiological assessment. The frontal and occipital Horn ratio had the most consistent correlation with the radiological assessment, followed by the Evans ratio. Objectively calculated volume change correlated poorly with radiological assessment.


CONCLUSIONS
Radiological interpretation does not correlate well with objectively calculated volume changes, but correlates better with other parameters that approximate volume and are likely used to visually evaluate interval change. We recommend that ventricle volume be objectively measured to increase consistency between radiological interpretation and actual interval changes.
Mann
Sumeer A
SA
Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, 103 Hospital Dr Saskatoon, Canada SK S7N 0W8.
Wilkinson
Jeffrey S
JS
Fourney
Daryl R
DR
Stoneham
Grant W
GW
D002552:Cerebral Ventricles / Q000033:anatomy & histology* / Q000473:pathology*; D014695:Cerebral Ventriculography / Q000379:methods*; D016001:Confidence Intervals; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery; D021621:Imaging, Three-Dimensional; D009929:Organ Size; D011856:Radiographic Image Enhancement / Q000379:methods; D012016:Reference Values; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt