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Cine Phase-Contrast MR Images Failed to Predict Clinical Outcome Following ETV

Published online by Cambridge University Press:  02 December 2014

Xiao Di ,
M. Ragab  and
Mark G. Luciano
Xiao Di*
Affiliation:
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
M. Ragab
Affiliation:
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
Mark G. Luciano
Affiliation:
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
*
Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, S90, Cleveland, Ohio, 44195, USA
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Abstract

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Background:

To predict success of endoscopic third ventriculostomy (ETV) in patients with obstructive hydrocephalus, we evaluated pre- and post- operative phase-contrast cine magnetic resonance images (PC MRI) on cerebrospinal fluid (CSF), cine flow in basal cisterns around the brain stem, and cervical medullar junction (CMJ) retrospectively.

Methods:

The study involved 102 patients with mean age of 36.74±23.25, and F/M = 1.55. All patients had PC MRI taken both pre- and post-operatively. A dynamic MRI video of PC MRI was reviewed at sagittal, axial, and coronal sections to determine cistern flows around the brain stem and CMJ. For quantitative analysis, quadrants were divided around midbrain axially to evaluate interpeduncular, quadrageminal, and ambient cisterns of both sides using scores of 0 to 60. Pre- and post- pontine and CMJ flows were shown in sagittal view and scored 0 to 20, and lateral cerebellopontine cisterns of both sides were measured on coronal image and scored 0 to 20.

Results:

No significant difference in CSF flow was seen from three individual views and total cine score, or between ETV success and failure groups by multivariate analysis of variance. Kaplan-Meier Analysis and Spearman's Correlation Test produced no relationship between MRI cine flow scores and interval period after surgery to ETV failure.

Conclusion:

PC MRI cine flow failed to demonstrate significant differences between successful and failed ETV groups. This indicates in addition to achieving an adequate fenestration, CSF pathways beyond the basal cisterns around the brain stem and CMJ may play an essential role in achieving ETV success.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 5 , September 2009 , pp. 643 - 647
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.de Ribaupierre, S, Rilliet, B, Vernet, O, Regli, L, Villemure, JG.Third ventriculostomy vs ventriculoperitoneal shunt in pediatric obstructive hydrocephalus: results from a Swiss series and literature review. Childs Nerv Syst. 2007;23(5):527–33.CrossRefGoogle ScholarPubMed
2.Hoffmann, KT, Lehmann, TN, Baumann, C, Felix, R.CSF flow imaging in the management of third ventriculostomy with a reversed fast imaging with steady-state precession sequence. Eur Radiol. 2003;13(6):1432–7.Google Scholar
3.Maeder, P, Gudinchet, F, Meuli, R, Fankhauser, H.Dynamic MRI of cerebrospinal fluid flow in endoscopic percutaneous ventriculostomy. Br J Neurosurg. 1998;12:18–22.Google Scholar
4.Goumnerova, LC, Frim, DM.Treatment of hydrocephalus with third ventriculocisternostomy: outcome and CSF flow patterns. Pediatr Neurosurg. 1997;27(3):149–52.Google Scholar
5.Kim, SK, Wang, KC, Cho, BK.Surgical outcome of pediatric hydrocephalus treated by endoscopic III ventriculostomy: prognostic factors and interpretation of postoperative neuroimaging. Childs Nerv Syst. 2000;16:161–9.CrossRefGoogle ScholarPubMed
6.Yamamoto, M, Oka, K, Ikeda, K, Tomonaga, M.Percutaneous flexible neuroendoscopic ventriculostomy in patients with shunt malfunction as an alternative procedure to shunt revision. Surg Neurol. 1994;42:218–23.CrossRefGoogle ScholarPubMed
7.Bargallo, N, Olondo, L, Garcia, AI, Capurro, S, Carol, L, Rumia, J.Functional analysis of third ventriculostomy patency by quantification of CSF stroke volume by using cine phasecontrast MR imaging. AJNR Am J Neuroradiol. 2005;26(10):2514–21.Google ScholarPubMed
8.Fukuhara, T, Luciano, MG, Kowalski, RJ.Clinical features of third ventriculostomy failures classified by fenestration patency. Surg Neurol. 2002;58(2):102–10.Google Scholar
9.Fukuhara, T, Vorster, SJ, Luciano, MG.Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery. 2000;46(5):1100–9; discussion 1109-11.Google Scholar
10.Fukuhara, T, Vorster, SJ, Ruggieri, P, Luciano, MG.Third ventriculostomy patency: comparison of findings at cine phasecontrast MR imaging and at direct exploration. AJNR Am J Neuroradiol. 1999;20(8):1560–6.Google Scholar
11.Lev, S, Bhadelia, RA, Estin, D, Heilman, CB, Wolpert, SM.Functional analysis of third ventriculostomy patency with phase-contrast MRI velocity measurements. Neuroradiology. 1997;39:175–9.CrossRefGoogle ScholarPubMed
12.Connor, SE, O’Gorman, R, Summers, P, Simmons, A, Moore, EM, Chandler, C, et al.SPAMM, cine phase contrast imaging and fast spin-echo T2-weighted imaging in the study of intracranial cerebrospinal fluid (CSF) flow. Clin Radiol. 2001;56(9):763–72.Google Scholar
13.Missir, O, Dormont, D, Pierot, L.MR visualization of CSF flow through a ventriculo-cisternostomy. Neuroradiology. 1989;31:93–4.Google Scholar
14.Rovira, A, Capellades, J, Grive, E, Poca, MA, Pedraza, S, Sauquillo, J, et al.Spontaneous ventriculostomy: report of three cases revealed by flow-sensitive phase-contrast cine MR imaging. AJNR Am J Neuroradiol. 1999;20(9):1647–52.Google ScholarPubMed
15.Carpentier, A, Brunelle, F, Philippon, J, Clemenceau, S.Obstruction of Magendie’s and Luschka’s foramina. Cine-MRI, aetiology and pathogenesis. Acta Neurochir (Wien). 2001;143(5):517–21.Google Scholar
16.Jallo, GI, Kothbauer, KF, Abbott, IR.Endoscopic third ventriculostomy. Neurosurg Focus. 2005;19(6):E11.Google Scholar
17.Cinalli, G, Sainte-Rose, C, Chumas, P, Zerah, M, Brunelle, F, Lot, G, et al.Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg. 1999;90(3):448–54.Google Scholar
18.Suehiro, T, Inamura, T, Natori, Y, Sasaki, M, Fukui, M.Successful neuroendoscopic third ventriculostomy for hydrocephalus and syringomyelia associated with fourth ventricle outlet obstruction. Case report. J Neurosurg. 2000;93(2):326–9.CrossRefGoogle ScholarPubMed
19.Teo, C, Jones, R.Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Pediatr Neurosurg. 1996;25:57–63.Google Scholar
20.Kehler, U, Gliemroth, J.Extraventricular intracisternal obstructive hydrocephalus - a hypothesis to explain successful 3rd ventriculostomy in communicating hydrocephalus. Pediatr Neurosurg. 2003;38(2):98–101.CrossRefGoogle ScholarPubMed
21.Johnston, M, Armstrong, D, Koh, L.Possible role of the cavernous sinus veins in cerebrospinal fluid absorption. Cerebrospinal Fluid Res. 2007;16;4(1):3.Google Scholar
22.Koh, L, Zakharov, A, Nagra, G, Armstrong, D, Friendship, R, Johnston, M.Development of cerebrospinal fluid absorption sites in the pig and rat: connections between the subarachnoid space and lymphatic vessels in the olfactory turbinates. Anat Embryol (Berl). 2006;211(4):335–44.CrossRefGoogle ScholarPubMed
23.Nagra, G, Koh, L, Zakharov, A, Armstrong, D, Johnston, M.Quantification of cerebrospinal fluid transport across the crib riform plate into lymphatics in rats. Am J Physiol Regul Integr Comp Physiol. 2006;291(5):R1383–9.Google Scholar
24.Woodworth, G, McGirt, MJ, Thomas, G, Williams, MA, Rigamonti, D.Prior CSF shunting increases the risk of endoscopic third ventriculostomy failure in the treatment of obstructive hydrocephalus in adults. Neurol Res. 2007;29(1):27–31.Google Scholar
25.Rekate, HL.Longstanding overt ventriculomegaly in adults: pitfalls in treatment with endoscopic third ventriculostomy. Neurosurg Focus. 2007;15;22(4):E6.Google Scholar
26.Kamel, MH, Kelleher, M, Aquilina, K, Lim, C, Caird, J, Kaar, G.Use of a simple intraoperative hydrostatic pressure test to assess the relationship between mobility of the ventricular stoma and success of third ventriculostomy. J Neurosurg. 2005;103(5):848–52.Google Scholar