A non-invasive assessment of intracranial volume reserve by measuring cerebrospinal fluid volume with the aid of CT imaging.
BACKGROUND
Monitoring changes in the intracranial volume (ICV) reserve and intracranial pressure (ICP) is one of the key issues in the treatment of intracranial pathologies. The aim of this study is to develop a method of monitoring the ICV reserve by analyzing CSF volume measured using CT in specific regions.


METHODS
A total of 20 patients with cerebral injury were evaluated. Analysis was performed using imaging software. On selected scans (three at the basal cistern level and three at the pineal level), the following regions were analyzed: total cerebral surface (TC1, TC2) and bilateral ambient cistern (AC) only at the basal cistern level for cerebrospinal fluid (CSF) volume. Results were correlated with patients' Glasgow Coma Scale (GCS) scores.


RESULTS
An increase of CSF volume was observed with an improvement in the GCS. From the examined regions, only AC volume showed a statistically significant linear correlation (p < 0.0005) with GCS. Mean AC: 0.021, 0.454, and 0.678 mL CSF/scan in severe (3-8 pts GCS), moderate (9-12 pts GCS), and mild (13-15 pts GCS) TBI groups, respectively.


CONCLUSIONS
Assessment of CSF volume changes in mL CSF/scan can be conducted using CT. Counting voxels corresponding to the CSF eliminates mistakes due to inaccurate region demarcation. The obtained results (AC volume) show a high correlation with patient state.
Glowacki
Mariusz
M
Department of Neurosurgery, M Mossakowski Medical Research Center, Polish Academy of Sciences, Warsaw, Poland.
Budohoski
Karol
K
Marszalek
Piotr
P
Walecki
Jerzy
J
Czernicki
Zbigniew
Z
D000328:Adult; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging* / Q000473:pathology; D001931:Brain Mapping; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008875:Middle Aged; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult