Aims and objectives
The aim of our study was to evaluate the diagnostic utility of three‑dimensional sampling perfection with application optimized contrast using different flip angle evolution (3D SPACE) sequence and Susceptibility Weighted Imaging (SWI) in hydrocephalus and to propose a refined definition and classification of hydrocephalus with relevance to the selection of treatment option.
Methods and materials
Study Design and Duration:
This prospective study was conducted in our institute from January 2014 to December 2017.
Approval was obtained from the ethical committee.
Patients with hydrocephalus who were referred for MRI brain were enrolled for our study.
Informed consent was obtained from all patients or caregivers.
We included 109 patients with moderate to severe hydrocephalus based on Evans index.
We excluded patients >50 years (due to age related dilatation of ventricles),
normal pressure hydrocephalus,
those patients with brain atrophy...
Out of 46 noncommunicating hydrocephalus diagnosed by conventional sequences,
direct obstruction was seen in 21 patients and indirect signs of obstruction were seen in 25 patients.
Direct obstruction included aqueductal membranes in two patients,
tectal glioma in one patient,
pineal tumor in two patients,
Arnold Chiari malformation in four patients,
and achondroplasia in one patient.
Lilliquist membrane was seen in one patient but was only partially visualized and could not be traced to its full extent.
Colloid cyst causing obstruction of foramen of Monro was...
3D SPACE sequence in hydrocephalus patients are very sensitive in differentiating obstructive from communicating hydrocephalus,
thereby selecting more patients as candidates for endoscopic procedures and reducing the need and complications of shunt procedures.
SWI sequence detected hemorrhage at multiple sites and helps to unveil the cause of hydrocephalus in many patients.
We recommend to include these sequences in the set of routine MRI sequences in cases of hydrocephalus and to follow the newer classification of hydrocephalus as the tool for selection of surgical options.
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