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Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography for the detection of spontaneous third ventriculostomy - 30/04/11

Doi : 10.1016/j.neurad.2010.03.006 
O. Algin a, , B. Hakyemez b, M. Parlak b
a Department of Radiology, Atatürk Training and Research Hospital, Bilkent, Ankara, Turkey 
b Department of Neuroradiology, Uludag University Medical Faculty, Gorukle, Bursa, Turkey 

Corresponding author. Tel.: +0905327064759.

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Summary

Purpose

To compare the diagnostic efficacies of phase-contrast MRI (PC-MRI) and three-dimensional constructive interference in steady-state (3D-CISS) sequence for the detection of spontaneous third ventriculostomy (STV) on the basis of contrast-enhanced MR cisternography (MRC).

Patients and methods

Eleven obstructive hydrocephalus patients with clinically-radiologically suspected STV and ten controls were examined by PC-MRI, 3D-CISS and MRC. PC-MRI and 3D-CISS sequence were applied to view the third ventricle and basal cisterns. Following injection of 0.5-1ml intrathecal Gd-DTPA injection, postcontrast MRC images were obtained in three planes. Presence of STV was scored as follows: grade 0, no existence of STV; grade 1, STV present. Results of PC-MRI and 3D-CISS were compared with the MRC findings.

Results

In PC-MRI, five patients were assessed as grade 0 and six cases grade 1. As a result of 3D-CISS sequence, eight cases were evaluated as grade 0 and three cases grade 1. Based on MRC, nine cases were assessed as grade 0 and two cases grade 1. False positivity was found in four cases by PC-MRI and in one case by 3D-CISS. The sensitivity, specificity and accuracy of PC-MRI and 3D-CISS sequence regarding demonstration of STV, were 100, 100, 56, 89, 64, and 91% respectively.

Discussion

PC-MRI and 3D-CISS are helpful in confirming the STV. PC-MRI and 3D-CISS should be the first preference. If PC-MRI and 3D-CISS give negative results, then MRC is not required. MRC should be performed on patients who demonstrate suspected STV findings on PC-MRI and 3D-CISS sequences. MRC may prevent false positive results.

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Keywords : Hydrocephalus, Magnetic resonance imaging, MR cisternography, PC cine MR, Spontaneous third ventriculostomy


Esquema


 This study was presented as a scientific presentation at the 48th ASNR Annual Meeting, Boston, Massachusetts, USA, May 17 to 20, 2010.


© 2010  Elsevier Masson SAS. Reservados todos los derechos.
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