title: Assessment of third ventriculostomy patency with the 3D-SPACE technique: a preliminary multicenter research study.
abstract: OBJECTIVE
  The goal of this study was to determine the value of the 3D sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) technique in the evaluation of endoscopic third ventriculostomy (ETV) patency.
  
  
  METHODS
  Twenty-six patients with ETV were examined using 3-T MRI units. Sagittal-plane 3D-SPACE with variant flip-angle mode, 3D T1-weighted (T1W), and 3D heavily T2-weighted (T2W) images were obtained with isotropic voxel sizes. Also, sagittal-axial plane phase-contrast cine (PC)-MR images were obtained. The following findings were evaluated: diameters of stoma and third ventricle, flow-void sign on 3D-SPACE and PC-MR images, integrity of the third ventricle on heavily T2W images, and quantitative PC-MRI parameters of the stoma. Obtained sequences were evaluated singly, in combination with one another, and all together.
  
  
  RESULTS
  The mean area, flow, and velocity values measured at the level of stoma in patients with patent stoma were significantly higher than those measured in patients with closed stoma (p < 0.05). There was significant correlation among PC-MRI, 3D-SPACE, and 3D heavily T2W techniques regarding assessment of ETV patency (p < 0.001). The 3D-SPACE technique provided the lowest rate of ambiguous results.
  
  
  CONCLUSIONS
  The 3D-SPACE technique seems to be the most efficient one for determination of ETV patency. The authors suggest the use of 3D-SPACE as a stand-alone first-line sequence in addition to routine brain MRI protocols in assessing patients with ETV, thereby decreasing scan time and reserving the use of a combination of additional sequences such as PC-MRI and 3D heavily T2W images in suspicious or complex cases.
authors: 1Department of Radiology, Ataturk Training and Research Hospital;|2Bilkent University, National MR Research Center (UMRAM), Bilkent, Ankara; 
authors: Oktay
authors: O
authors: Algin
authors: Departments of 3Radiology and.
authors: Murat
authors: M
authors: Ucar
authors: 1Department of Radiology, Ataturk Training and Research Hospital;
authors: Evrim
authors: E
authors: Ozmen
authors: 4Neurosurgery, Gazi University Medical Faculty;
authors: Alp Ozgun
authors: AO
authors: Borcek
authors: 5Neurosurgery Clinic, Koru Hospital, Ankara; and.
authors: Pinar
authors: P
authors: Ozisik
authors: 6Biostatistics, Uludag University, Gorukle, Bursa, Turkey.
authors: Gokhan
authors: G
authors: Ocakoglu
authors: Departments of 3Radiology and.
authors: E Turgut
authors: ET
authors: Tali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000601:surgery*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery*; D014696:Ventriculostomy / Q000379:methods*; D055815:Young Adult
keywords: 3D sampling perfection with application-optimized contrasts using different flip-angle evolutions; 3D-SPACE = 3D sampling perfection with application-optimized contrasts using different flip-angle evolutions; ETV = endoscopic third ventriculostomy; PC = phase-contrast cine; T1W, T2W = T1-, T2-weighted; cerebrospinal fluid; endoscopic third ventriculostomy; magnetic resonance imaging; obstructive hydrocephalus; ventriculoperitoneal shunt