title: Role of magnetic resonance ventriculography in multiloculated hydrocephalus.
abstract: OBJECTIVE
  In this paper the authors' goal was to investigate the clinical usefulness of Gd-enhanced MR ventriculography (MRV) in pediatric patients affected by multiloculated hydrocephalus.
  
  
  METHODS
  Eighteen patients (11 boys and 7 girls, age range 2-14 months) with a diagnosis of multiloculated hydrocephalus were included in the study. After injection of gadodiamide (0.02-0.04 mmol) into the lateral ventricle by tapping the anterior fontanel, sagittal, coronal, and axial T1-weighted MR images were acquired. The location of the septations and the sites of obstruction of CSF flow were assessed. Postoperative MRV was obtained to confirm the results of endoscopic treatment in most complex cases.
  
  
  RESULTS
  No adverse events were observed after injection of contrast medium into the ventricular system. Preoperative MRV accurately defined the exact morphology of septae and ventricular walls in all cases. In 1 case the diagnosis of multiloculated hydrocephalus was ruled out. Sites of obstruction of CSF flow within the ventricular system were also well established. In 4 cases the multiple compartments were proven to intercommunicate. Postoperative MRV was useful in assessing the functional status of third ventriculostomy, aqueductoplasty, and other endoscopic fenestrations.
  
  
  CONCLUSIONS
  Magnetic resonance ventriculography is a safe, effective, and reliable technique. The accurate definition of the anatomy of the ventricles and the site of obstruction in multiloculated hydrocephalus can help to plan the most appropriate treatment and minimize the number of procedures. Although MRV is also useful during postoperative follow-up to determine the results of endoscopic treatment, it should be limited to particularly complex cases, due to its invasiveness.
authors.affiliation: Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India. gurpreet.gandhoke@gmail.com
authors.forename: Gurpreet S
authors.initials: GS
authors.lastname: Gandhoke
authors.forename: Paolo
authors.initials: P
authors.lastname: Frassanito
authors.forename: Nagesh
authors.initials: N
authors.lastname: Chandra
authors.forename: Bal K
authors.initials: BK
authors.lastname: Ojha
authors.forename: Anoop
authors.initials: A
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D014695:Cerebral Ventriculography / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D044583:Neuroendoscopy; D011237:Predictive Value of Tests; D020542:Third Ventricle; D014696:Ventriculostomy
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA