Skip to main content
SpringerLink
Log in

CSF flow imaging in the management of third ventriculostomy with a reversed fast imaging with steady-state precession sequence

  • Neuro
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract.

The aim of this study was evaluation of a fast and slow-flow sensitive 2D steady-state free-precession sequence for its capability to prove the patency of endoscopic third ventriculostomy (TVS) in obstructive hydrocephalus, and to exclude communicating third ventricle prior to TVS. We compared gated and ungated variants of this sequence for this purpose. Twenty-three patients with obstructive hydrocephalus underwent 36 MR examinations with a 2D reversed fast imaging with steady-state precession (PSIF) sequence in a retrospectively cardiac gated (cine) and a faster but ungated version beside T1- and T2-weighted sequences in three planes. Thirteen patients were examined both before and after TVS, 4 patients solely before, and 6 patients solely after TVS. Imaging diagnoses were compared with intraoperative findings and clinical findings after TVS. Preoperative diagnosis of non-communicating third ventricle and cisterns was intraoperatively confirmed in 16 of 17 cases. Preoperative MRI was inconclusive in 1 case. Postoperative MRI revealed sufficient TVS in 16 of 19 cases and obstructed TVS in 3 of 19 cases due to several reasons. Findings at MRI were consistent in 19 of 19 cases with the clinical course and intraoperative results. The faster but ungated PSIF sequence was found to be diagnostically equivalent to the cardiac gated cine sequence. The CSF flow imaging with a 2D reversed fast imaging with steady-state precession sequence in conjunction with conventional T1- and T2-weighted images is a fast and reliable tool for pre- and postoperative functional evaluation in third ventriculostomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. Kulkarni AV, Drake JM, Armstrong DC, Dirks PB (2000) Imaging correlates of successful third ventriculostomy. J Neurosurg 92:915–919

    CAS  PubMed  Google Scholar 

  2. Missir O, Dormont D, Pierot L (1989) MR visualization of CSF flow through a ventriculo-cisternostomy. Neuroradiology 31:93–94

    CAS  PubMed  Google Scholar 

  3. Maeder P, Gudinchet F, Meuli R, Fankhauser H (1998) Dynamic MRI of cerebrospinal fluid flow in endoscopic percutaneous ventriculostomy. Br J Neurosurg 12:18–22

    Article  CAS  PubMed  Google Scholar 

  4. Wilcock DJ, Jaspan T, Worthington BS, Punt J (1997) Neuro-endoscopic third ventriculostomy: evaluation with magnetic resonance imaging. Clin Radiol 52:50–54

    CAS  PubMed  Google Scholar 

  5. Jack CR Jr, Kelly PJ (1989) Stereotactic third ventriculostomy: assessment of patency with MR imaging. Am J Neuroradiol 10:512–522

    Google Scholar 

  6. Kim SK, Wang KC, Cho BK (2000) Surgical outcome of pediatric hydrocephalus treated by endoscopic III ventriculostomy: prognostic factors and interpretation of postoperative neuroimaging. Childs Nerv Syst 16:161–169

    CAS  PubMed  Google Scholar 

  7. Lev S, Bhadelia RA, Estin D, Heilman CB, Wolpert SM (1997) Functional analysis of third ventriculostomy patency with phase-contrast MRI velocity measurements. Neuroradiology 39:175–179

    Article  CAS  PubMed  Google Scholar 

  8. Rovira A, Capellades J, Grive E et al. (1999) Spontaneous ventriculostomy: report of three cases revealed by flow-sensitive phase-contrast cine MR imaging. Am J Neuroradiol 20:1647–1652

    CAS  Google Scholar 

  9. Fukuhara T, Vorster SJ, Ruggieri P, Luciano MG (1999) Third ventriculostomy patency: comparison of findings at cine phase-contrast MR imaging and at direct exploration. Am J Neuroradiol 20:1560–1566

    CAS  Google Scholar 

  10. Foroutan M, Mafee MF, Dujovny M (1998) Third ventriculostomy, phase-contrast cine MRI and endoscopic techniques. Neurol Res 20:443–448

    CAS  PubMed  Google Scholar 

  11. Kim MH, Shin KM, Song JH (1998) Cine MR CSF flow study in hydrocephalus: What are the valuable parameters? Acta Neurochir (Suppl) 71:343–346

    Google Scholar 

  12. Goumnerova LC, Frim DM (1997) Treatment of hydrocephalus with third ventriculostomy: outcome and CSF flow patterns. Pediatr Neurosurg 27:149–152

    CAS  PubMed  Google Scholar 

  13. Connor SE, O'Gorman R, Summers P et al. (2001) Spamm, cine phase contrast imaging and fast spin-echo T2-weighted imaging in the study of intracranial cerebrospinal fluid (CSF) flow. Clin Radiol 56:763–772

    Article  CAS  PubMed  Google Scholar 

  14. Laitt RD, Mallucci CL, Jaspan T, McConachie NS, Vloeberghs M, Punt J (1999) Constructive interference in steady-state 3D Fourier-transform MRI in the management of hydrocephalus and third ventriculostomy. Neuroradiology 41:117–123

    Article  CAS  PubMed  Google Scholar 

  15. Hoffmann KT, Hosten N, Meyer BU et al. (2000) CSF flow studies of intracranial cysts and cyst-like lesions achieved using reversed fast imaging with steady-state precession MR sequences. Am J Neuroradiol 21:493–502

    CAS  Google Scholar 

  16. Patz S, Hawkes RC (1986) The application of steady-state free precession to the study of very slow fluid flow. Magn Reson Med 3:140–145

    CAS  PubMed  Google Scholar 

  17. Jolesz FA, Patz S, Hawkes RC, Lopez I (1987) Fast imaging of CSF flow/motion patterns using steady-state free precession (SSFP). Invest Radiol 22:761–771

    CAS  PubMed  Google Scholar 

  18. Axel L, Dougherty L (1989) MR imaging of motion with spatial modulation of magnetization. Radiology 171:841–845

    CAS  PubMed  Google Scholar 

  19. Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C (1998) The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 43:1323–1329

    CAS  PubMed  Google Scholar 

  20. Bruder H, Fischer H, Graumann R, Deimling M (1988) A new steady-state imaging sequence for simultaneous acquisition of two MR images with clearly different contrasts. Magn Reson Med 7:35–42

    CAS  PubMed  Google Scholar 

  21. Schellinger D, Le Bihan D, Rajan SS et al. (1992) MR of slow CSF flow in the spine. Am J Neuroradiol 13:1393–1403

    CAS  Google Scholar 

  22. Kelly PJ (1991) Stereotactic third ventriculostomy in patients with nontumoral adolescent/adult onset aqueductal stenosis and symptomatic hydrocephalus. J Neurosurg 75:865–873

    CAS  PubMed  Google Scholar 

  23. Quencer RM (1992) Intracranial CSF flow in pediatric hydrocephalus: evaluation with cine-MR imaging. Am J Neuroradiol 13:601–608

    CAS  Google Scholar 

  24. Casselman JW, Kuhweide R, Deimling M, Ampe W, Dehaene I, Meeus L (1993) Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle. Am J Neuroradiol 14:47–57

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Charité, Campus Virchow-Klinikum, Humboldt University Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Karl T. Hoffmann, Clemens Baumann & Roland Felix

  2. Department of Neurosurgery, Charité, Campus Virchow-Klinikum, Humboldt University Berlin, Augustenburger Platz 1, 13353 , Berlin, Germany

    Thomas N. Lehmann

Authors
  1. Karl T. Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas N. Lehmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Clemens Baumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roland Felix
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karl T. Hoffmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hoffmann, K.T., Lehmann, T.N., Baumann, C. et al. CSF flow imaging in the management of third ventriculostomy with a reversed fast imaging with steady-state precession sequence. Eur Radiol 13, 1432–1437 (2003). https://doi.org/10.1007/s00330-002-1776-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-002-1776-5

Keywords

Search

Navigation