Abstract
Introduction
Liliequist membrane (LM) is the most important anatomic structure for the success of endoscopic third ventriculostomy (ETV). Identification of this membrane is difficult with conventional MRI techniques. The purpose of this retrospective study is to determine the impact of three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) sequence with variant flip-angle mode (VFAM) in the assessment of LM at 3-T MRI devices.
Methods
3D-SPACE with VFAM images were obtained in 445 patients. LM visibility and integrity were scored as 0 (good), 1 (moderate), and 2 (poor) on these images for each parts (sellar, diencephalic, and mesencephalic) and overall of the membrane.
Results
According to the LM overall integrity scores, 11 % (48 cases) of the patients had perforated membrane. According to subsegmental integrity scores, sellar part was completely intact in 63 % of patients, diencephalic segment was completely intact in 60 % of the patients, and mesencephalic segment was completely intact in 95 % of the patients. Visibility scores of the third ventricle inferior wall were significantly higher in the patients with intact LM (p = 0.001). There was not any statistically significant relationship between LM pattern and overall integrity (p = 0.352). LM attachment sites could be detected easier in the patients who had better visibility of third ventricle inferior wall or intact LM (p < 0.001 for both).
Conclusion
3D-SPACE technique is a useful alternative for the evaluation of morphology, integrity, individual variations, topographic relationships, and visibility of LM since it has some advantages including lower SAR values, fewer artifacts, and high-resolution images.
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Acknowledgments
Some study subjects have been previously reported in our previously published 3D-SPACE papers; however, this paper is entirely different than previously published studies.
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We declare that our study has been approved by the Ataturk Training and Research Hospital Ethics Committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
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We declare that we have no conflict of interest.
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Algin, O., Kılın, M., Ozmen, E. et al. Assessment of Liliequist membrane by 3D-SPACE technique at 3 T. Neuroradiology 58, 637–647 (2016). https://doi.org/10.1007/s00234-016-1669-y
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DOI: https://doi.org/10.1007/s00234-016-1669-y