title: Feasibility of 3-dimensional sampling perfection with application optimized contrast sequence in the evaluation of patients with hydrocephalus.
abstract: OBJECTIVE
  This study aimed to investigate the effectiveness and additive value of T2W 3-dimensional sampling perfection with application optimized contrast (3D-SPACE) with variant flip-angle mode in imaging of all types of hydrocephalus. Our secondary objective was to assess the reliability of 3D-SPACE sequence and correspondence of the results with phase-contrast magnetic resonance imaging (PC-MRI)-based data.
  
  
  METHODS
  Forty-one patients with hydrocephalus have undergone 3-T MRI. T2W 3D-SPACE sequence has been obtained in addition to routine hydrocephalus protocol. Cerebrospinal fluid circulation, presence/type/etiology of hydrocephalus, obstruction level scores, and diagnostic levels of confidence were evaluated separately by 2 radiologists. In the first session, routine sequences with PC-MRI were evaluated, and in another session, only 3D-SPACE and 3-dimensional magnetization prepared rapid acquisition gradient echo sequences were evaluated. Results obtained in these sessions were compared with each other and those obtained in consensus session.
  
  
  RESULTS
  Agreement values were very good for both 3D-SPACE and PC-MRI sequences (P < 0.001 for all). Also, the correlation of more experienced reader's 3D-SPACE-based scores and consensus-based scores was perfect (κ = 1, P < 0.001).The mean value of PC-MRI-based confidence scores were lower than those obtained in 3D-SPACE and consensus sessions.
  
  
  CONCLUSIONS
  T2W 3D-SPACE sequence provides morphologic cerebrospinal fluid flow data. It is a noninvasive technique providing extensive multiplanar reformatted images with a lower specific absorption rate. These advantages over PC-MRI make 3D-SPACE sequence a promising tool in management of patients with hydrocephalus.
authors.affiliation: From the *Department of Radiology, Ataturk Training and Research Hospital, Ankara; †Department of Biostatistics, Uludag University, Medical Faculty, Gorukle, Bursa; and ‡Bilkent University, National MR Research Center (UMRAM), Bilkent, Ankara, Turkey.
authors.forename: Merve Gulbiz
authors.initials: MG
authors.lastname: Kartal
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ocakoglu
authors.forename: Oktay
authors.initials: O
authors.lastname: Algin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002648:Child; D005240:Feasibility Studies; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology*; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult