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Magnetic resonance elastography in normal pressure hydrocephalus—a scoping review

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A Correspondence to this article was published on 29 September 2022

Abstract

Background

Magnetic resonance elastography (MRE) of the brain allows quantitative measurement of tissue mechanics. Multiple studies are exploring possible applications in normal pressure hydrocephalus (NPH) in clinical and paraclinical contexts. This is of great interest in neurological surgery due to challenges related to diagnosis and prediction of treatment effects. In this scoping review, we present a topical overview and discuss the current literature, with particular attention to clinical implications and current challenges.

Methods

The protocol was based on the PRISMA extension for scoping reviews. After a systematic database search (PubMed, Embase, and Web of Science), the articles were screened for relevance. Thirty articles were subject to detailed screening, and key technical and clinical data items were extracted. The inclusion criteria included the use of MRE on human subjects with NPH.

Results

Seven articles were included in the final study. These studies had various objectives including the role of MRE in the assessment of regional elastic changes in NPH, shunt effect, and evaluation of NPH symptoms. MRE revealed patterns of mechanical changes in NPH that differed from other dementias. Regional MRE changes were associated with specific NPH signs and symptoms. Neurosurgical shunting caused partial normalization in tissue scaffold parameters. The studies were highly heterogeneous in technical aspects and design.

Conclusion

MRE studies in NPH are still limited by few participants, variable cohorts, inconsistent methodologies, and technical challenges, but the approach shows great potential for future clinical application.

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Acknowledgements

We wish to thank Alioune Badara Diop and ADA Arkitektur for their assistance with the graphical design.

Furthermore, we wish to thank MD-PhD Claire Gudex—medial writer—for contributing with proofreading and document editing.

Funding

The study was supported by the Lundbeck Foundation through the pregraduate neurosurgical scholarship.

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Authors and Affiliations

  1. Department of Neurosurgery, Odense University Hospital, Kløvervænget 47, Entrance 44, 5000, Odense C, Denmark

    Jan Saip Aunan-Diop, Christian Bonde Pedersen, Bo Halle, Sune Munthe, Bjarni Johannsson & Frantz Rom Poulsen

  2. University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark

    Jan Saip Aunan-Diop & Frantz Rom Poulsen

  3. Department of Radiology, Odense University Hospital, Kløvervænget 47, Entrance 27, 5000, Odense C, Denmark

    Ulla Jensen & Fredrik Harbo

Authors
  1. Jan Saip Aunan-Diop
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Contributions

JSA-D: main author, database search, screening

CBP: writing, proofreading, commenting, and supervising

BH: writing, proofreading, commenting, and supervising

UJ: writing, proofreading, and commenting

SM: writing, proofreading, and commenting

FH: writing, proofreading, and commenting

BJ: writing, proofreading, and commenting

FRP: writing, screening, proofreading, commenting, and main supervisor

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Correspondence to Jan Saip Aunan-Diop.

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Aunan-Diop, J.S., Pedersen, C.B., Halle, B. et al. Magnetic resonance elastography in normal pressure hydrocephalus—a scoping review. Neurosurg Rev 45, 1157–1169 (2022). https://doi.org/10.1007/s10143-021-01669-0

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