Assessment of third ventriculostomy patency with the 3D-SPACE technique: a preliminary multicenter research study
Author
Algın, Oktay
Uçar, M.
Ozmen, E.
Borcek, A.
Ozisik, P.
Ocakoglu, G.
Tali, E.
Date
2015Source Title
Journal of Neurosurgery
Publisher
American Association of Neurological Surgeons
Volume
122
Issue
6
Pages
1347 - 1355
Language
English
Type
ArticleItem Usage Stats
63
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36
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Abstract
Object The goal of this study was to determine the value of the 3D sampling perfection with application-optimized
contrasts using different flip-angle evolutions (3D-SPACE) technique in the evaluation of endoscopic third ventriculostomy
(ETV) patency.
Methods Twenty-six patients with ETV were examined using 3-T MRI units. Sagittal-plane 3D-SPACE with variant
flip-angle mode, 3D T1-weighted (T1W), and 3D heavily T2-weighted (T2W) images were obtained with isotropic voxel
sizes. Also, sagittal-axial plane phase-contrast cine (PC)-MR images were obtained. The following findings were evaluated:
diameters of stoma and third ventricle, flow-void sign on 3D-SPACE and PC-MR images, integrity of the third ventricle
on heavily T2W images, and quantitative PC-MRI parameters of the stoma. Obtained sequences were evaluated
singly, in combination with one another, and all together.
Results The mean area, flow, and velocity values measured at the level of stoma in patients with patent stoma were
significantly higher than those measured in patients with closed stoma (p < 0.05). There was significant correlation
among PC-MRI, 3D-SPACE, and 3D heavily T2W techniques regarding assessment of ETV patency (p < 0.001). The
3D-SPACE technique provided the lowest rate of ambiguous results.
Conclusions The 3D-SPACE technique seems to be the most efficient one for determination of ETV patency. The
authors suggest the use of 3D-SPACE as a stand-alone first-line sequence in addition to routine brain MRI protocols
in assessing patients with ETV, thereby decreasing scan time and reserving the use of a combination of additional sequences
such as PC-MRI and 3D heavily T2W images in suspicious or complex cases.
Keywords
Magnetic resonance imagingObstructive hydrocephalus
Cerebrospinal fluid
3D sampling perfection with application-optimized contrasts using different flip-angle evolution
Endoscopic third ventriculostomy
Ventriculoperitoneal shunt