Background: We investigated whether the presence of dural sinus narrowing is a more reliable marker of intracranial hypertension / shunt failure in children than the imaging finding of hydrocephalus. -Methods: Cranial MRIs of n=12 children were included when being well and when there was definitive intracranial hypertension as per follow-up and intraoperative results (gold standard). Images werde assessed for hydrocephalus on T2w images and narrowing of dural sinuses on MR vengraphy (diameter of <50%). Results: Dural sinuses narrowing was detected with a sensitivity of 0.67, a specificity of 1.0, PPV of 1.0 and NPV of 0.75 (Table 1). Hydrocephalus was detected with a sensitivity of 0.5, a specificity of 0.83, PPV of 0.75 and NPV of 0.63. Results differed between the test methods (p = 0.01, Cochrane Q test). Conclusions: Dural sinus narrowing more reliably predicted intracranial hypertension, a sign which might significantly improve care in critically ill children. | Age at MRI | Shuntfailure as per clinical follow-up(Goldstandard) | Hydrocephalus | Dural Sinus Narrowing |
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Patient # | Years | 1 = yes2 = no | 1 = yes2 = no | 1 = yes2 = no |
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1 | 1 | 1 | 1 | 0 |
| 4 | 0 | 0 | 0 |
2 | 6 | 1 | 1 | 1 |
| 6 | 0 | 0 | 0 |
3 | 12 | 1 | 0 | 1 |
| 12 | 0 | 0 | 0 |
4 | 18 | 1 | 0 | 1 |
| 19 | 0 | 0 | 0 |
5 | 0 | 1 | 1 | 0 |
| 1 | 0 | 1 | 0 |
6 | 0 | 0 | 1 | 0 |
| 0 | 1 | 1 | 0 |
7 | 17 | 1 | 0 | 1 |
| 17 | 0 | 0 | 0 |
8 | 10 | 1 | 1 | 1 |
| 10 | 0 | 0 | 0 |
9 | 0 | 1 | 1 | 1 |
| 1 | 0 | 0 | 0 |
10 | 8 | 1 | 0 | 1 |
| 8 | 0 | 0 | 0 |
11 | 14 | 1 | 0 | 1 |
| 14 | 0 | 0 | 0 |
12 | 18 | 1 | 0 | 0 |
| 18 | 0 | 0 | 0 |
| | Shuntfailure(Goldstandard) |
| | Affected | Nonaffected | total |
Hydrocephalus | Positive | 6 | 1 | 8 |
| Negative | 6 | 10 | 16 |
| | 12 | 12 | 24 |
| | Shuntfailure(Goldstandard) |
| | Affected | Nonaffected | total |
Dural Sinus Narrowing | Positive | 8 | 0 | 8 |
| Negative | 4 | 12 | 16 |
| | 12 | 12 | |