title: Assessment of Liliequist membrane by 3D-SPACE technique at 3 T.
abstract: BACKGROUND
  Liliequist membrane (LM) is the most important anatomic structure for the success of endoscopic third ventriculostomy (ETV). Identification of this membrane is difficult with conventional MRI techniques. The purpose of this retrospective study is to determine the impact of three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) sequence with variant flip-angle mode (VFAM) in the assessment of LM at 3-T MRI devices.
  
  
  METHODS
  3D-SPACE with VFAM images were obtained in 445 patients. LM visibility and integrity were scored as 0 (good), 1 (moderate), and 2 (poor) on these images for each parts (sellar, diencephalic, and mesencephalic) and overall of the membrane.
  
  
  RESULTS
  According to the LM overall integrity scores, 11 % (48 cases) of the patients had perforated membrane. According to subsegmental integrity scores, sellar part was completely intact in 63 % of patients, diencephalic segment was completely intact in 60 % of the patients, and mesencephalic segment was completely intact in 95 % of the patients. Visibility scores of the third ventricle inferior wall were significantly higher in the patients with intact LM (p = 0.001). There was not any statistically significant relationship between LM pattern and overall integrity (p = 0.352). LM attachment sites could be detected easier in the patients who had better visibility of third ventricle inferior wall or intact LM (p < 0.001 for both).
  
  
  CONCLUSIONS
  3D-SPACE technique is a useful alternative for the evaluation of morphology, integrity, individual variations, topographic relationships, and visibility of LM since it has some advantages including lower SAR values, fewer artifacts, and high-resolution images.
authors.affiliation: Department of Radiology, Ataturk Training and Research Hospital, 06050, Ankara, Turkey. droktayalgin@gmail.com.
authors.forename: Oktay
authors.initials: O
authors.lastname: Algin
authors.affiliation: Department of Radiology, Ataturk Training and Research Hospital, 06050, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kılın
authors.affiliation: Radiology Department, Istanbul University, Cerrahpasa Medical School Hospital, Istanbul, Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Ozmen
authors.affiliation: Biostatistics, Uludag University, Gorukle, Bursa, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ocakoglu
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging* / Q000473:pathology; D001099:Arachnoid / Q000000981:diagnostic imaging* / Q000473:pathology; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; 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; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: 3D-SPACE; CSF; Liliequist’s membrane; MRI; Third ventriculostomy