Three-Dimensional Constructive Interference in Steady State Sequences and Phase-Contrast Magnetic Resonance Imaging of Arrested Hydrocephalus.
OBJECTIVE
To evaluate the role of three-dimensional constructive interference in steady state (3D-CISS) sequences and phase-contrast magnetic resonance imaging (PC-MRI) in patients with arrested hydrocephalus.


METHODS
A prospective study of 20 patients with arrested hydrocephalus was carried out. All patients underwent PC-MRI and 3D-CISS for assessment of the aqueduct. Axial (through-plane), sagittal (in-plane) PC-MRI, and sagittal 3D-CISS were applied to assess the cerebral aqueduct and the spontaneous third ventriculostomy if present. Aqueductal patency was graded using 3D-CISS and PC-MRI. Quantitative analysis of flow through the aqueduct was performed using PC-MRI.


RESULTS
The causes of obstruction were aqueductal obstruction in 75% (n = 15), third ventricular obstruction in 5% (n = 1), and fourth ventricular obstruction in 20% (n = 4). The cause of arrest of hydrocephalus was spontaneous third ventriculostomy in 65% (n = 13), endoscopic third ventriculostomy in 10% (n = 2), and ventriculoperitoneal shunt in 5% (n = 1), and no cause could be detected in 20% of patients (n = 4). There is a positive correlation (r = 0.80) and moderate agreement (κ = 0.509) of grading with PC-MRI and 3D-CISS sequences. The mean peak systolic velocity of cerebrospinal fluid was 1.86 ± 2.48 cm/second, the stroke volume was 6.43 ± 13.81 μL/cycle, and the mean flow was 0.21 ± 0.32 mL/minute.


CONCLUSIONS
We concluded that 3D-CISS and PC-MRI are noninvasive sequences for diagnosis of the level and cause of arrested hydrocephalus.
Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt.
Fatma
F
Elkafrawy
Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt.
Ihab
I
Reda
Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt.
Mohamed
M
Elsirafy
Department of Diagnostic Radiology, National Liver Institute, El-Menoufia University, Al Minufya, Egypt.
Mohamed Saied Abdel
MS
Gawad
Department of Neurosurgery, Alexandria Faculty of Medicine, Alexandria, Egypt.
Alaa
A
Elnaggar
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt. Electronic address: arazek@mans.edu.eg.
Ahmed Abdel
AA
Khalek Abdel Razek
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
Arrested; Hydrocephalus; Phase-contrast MRI; Third ventriculostomy