title: Evaluation of aqueductal patency in patients with hydrocephalus: three-dimensional high-sampling-efficiency technique (SPACE) versus two-dimensional turbo spin echo at 3 Tesla.
abstract: OBJECTIVE
  To compare the accuracy of diagnosing aqueductal patency and image quality between high spatial resolution three-dimensional (3D) high-sampling-efficiency technique (sampling perfection with application optimized contrast using different flip angle evolutions [SPACE]) and T2-weighted (T2W) two-dimensional (2D) turbo spin echo (TSE) at 3-T in patients with hydrocephalus.
  
  
  METHODS
  This retrospective study included 99 patients diagnosed with hydrocephalus. T2W 3D-SPACE was added to the routine sequences which consisted of T2W 2D-TSE, 3D-constructive interference steady state (CISS), and cine phase-contrast MRI (PC-MRI). Two radiologists evaluated independently the patency of cerebral aqueduct and image quality on the T2W 2D-TSE and T2W 3D-SPACE. PC-MRI and 3D-CISS were used as the reference for aqueductal patency and image quality, respectively. Inter-observer agreement was calculated using kappa statistics.
  
  
  RESULTS
  The evaluation of the aqueductal patency by T2W 3D-SPACE and T2W 2D-TSE were in agreement with PC-MRI in 100% (99/99; sensitivity, 100% [83/83]; specificity, 100% [16/16]) and 83.8% (83/99; sensitivity, 100% [67/83]; specificity, 100% [16/16]), respectively (p < 0.001). No significant difference in image quality between T2W 2D-TSE and T2W 3D-SPACE (p = 0.056) occurred. The kappa values for inter-observer agreement were 0.714 for T2W 2D-TSE and 0.899 for T2W 3D-SPACE.
  
  
  CONCLUSIONS
  Three-dimensional-SPACE is superior to 2D-TSE for the evaluation of aqueductal patency in hydrocephalus. T2W 3D-SPACE may hold promise as a highly accurate alternative treatment to PC-MRI for the physiological and morphological evaluation of aqueductal patency.
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ucar
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Guryildirim
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Nil
authors.initials: N
authors.lastname: Tokgoz
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Kilic
authors.affiliation: Department of Neurosurgery, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Alp
authors.initials: A
authors.lastname: Borcek
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Oner
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Akkan
authors.affiliation: Department of Radiology, School of Medicine, Gazi University, Ankara 06510, Turkey.
authors.forename: Turgut
authors.initials: T
authors.lastname: Tali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging*; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: 3D-SPACE; Aqueductal patency; Cerebrospinal fluid flow; Hydrocephalus; MRI