Keywords:
Neuroradiology brain, Radiation physics, Radioprotection / Radiation dose, CT, Image manipulation / Reconstruction, Comparative studies, Technical aspects, Technology assessment, Dosimetric comparison, Image verification, Quality assurance
Authors:
S. Afat1, G. Homann1, M. A. Brockmann2, H. Clusmann3, H. A. Hamou3, M. Wiesmann3, K. Nikolaou1, A. E. Othman1; 1Tübingen/DE, 2Mainz/DE, 3Aachen/DE
DOI:
10.26044/ecr2019/C-3175
Aims and objectives
Placement of Ventriculoperitoneal (VP)-shunt is a standard procedure for the treatment of hydrocephalus for various conditions like normal pressure hydrocephalus (NPH),
intracranial hemorrhage,
aneurysmal subarachnoid hemorrhage,
meningitis,
tumor,
or trauma.
Despite being widely used,
the rate of shunt failure after 1 year has been reported to be between 20% to 40% of VP-shunts requiring revision within 6 years of placement (1,2).
These VP-shunts require often revision surgeries that can affect quality of life.
In case of suspected VP shunt malfunction,
a computed tomography (CT) head scan and radiographic shunt series (SS) are usually performed.
The radiographic SS visualize possible mechanical failures.
In a recent experimental study,
a whole-body LD-CT protocol was proposed to assess the complete course of VP shunts.
The new LD-CT protocol showed an excellent sensitivity and higher diagnostic confidence for shunt complications with lower radiation exposure compared with SS (3,4).
This present study is to investigate the diagnostic performance of Whole-body Low-Dose CT (LD-CT) in patients for detecting mechanical ventriculoperitoneal shunt (VP)-Shunt complications.
Fig.1:Three-dimensional reconstruction of whole-body LD-CT (right) and a sagittal Maximum Intensity Projection scan (left) showing the course of a normal VP-Shunt.