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Radiologic evaluation of pediatric hydrocephalus

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Abstract

Introduction

The aim of this review is to present the contemporary role of radiology in evaluating pediatric hydrocephalus. Although conventional brain imaging with ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) reveal the degree of ventricular enlargement and often the etiology of the hydrocephalus, the diagnosis and management of hydrocephalus present common problems in pediatric populations.

Discussion

US, usually sufficient to assess and monitor ventricular size, is used most commonly in preterm infants who have germinal matrix hemorrhages and not able to tolerate transport to the radiology department. Although CT can demonstrate gross dilatation of ventricles, in most cases, it will be necessary to more closely define the nature of the obstruction, either functionally or anatomically. MRI is the best imaging modality to provide such functional and anatomic information. However, since identification of obstructive pathologic processes at any level through the cerebrospinal fluid (CSF) pathway in patients with hydrocephalus is of significant importance because it can change the treatment options, avoiding shunt insertion, a more sophisticated MRI approach is needed instead of obtaining a routine cranial MRI. Furthermore, the outcome after neuroendoscopic procedures is clearly related to patient selection under guidance of neuroimaging.

Conclusion

Therefore, the article focuses mainly on the effective usage of various MRI sequences in both diagnosis and follow-up of pediatric hydrocephalus, such as 3D CISS, cine PC, TSE, and GRE T2* sequences, to be able to investigate all possible obstructive pathology through the CSF pathway and to assess the efficiency of treatment in a standardized way.

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References

  1. Aleman J, Jokura H, Higano S, Akabane A, Shirane R, Yoshimoto T (2001) Value of constructive interference in steady-state three-dimensional, Fourier transformation magnetic resonance imaging for the neuroendoscopic treatment of hydrocephalus and intracranial cysts. Neurosurgery 48:1291–1295, discussion 1295–1296

    PubMed  CAS  Google Scholar 

  2. Anik I, Ceylan S, Koc K, Anik Y, Etus V, Genc H (2011) Membranous structures affecting the success of endoscopic third ventriculostomy in adult aqueductus sylvii stenosis. Minim Invasive Neurosurg 54:68–74

    Article  PubMed  CAS  Google Scholar 

  3. Bartelt D, Jordan CE, Strecker EP, James AE (1975) Comparison of ventricular enlargement and radiopharmaceutical retention: a cisternographic–pneumoencephalographic comparison. Radiology 116:111–115

    PubMed  CAS  Google Scholar 

  4. Dincer A, Yener U, Ozek MM (2011) Hydrocephalus in patients with neurofibromatosis type 1: MR imaging findings and the outcome of endoscopic third ventriculostomy. AJNR Am J Neuroradiol 32:643–646

    Article  PubMed  CAS  Google Scholar 

  5. Dincer A, Yildiz E, Kohan S, Memet Ozek M (2011) Analysis of endoscopic third ventriculostomy patency by MRI: value of different pulse sequences, the sequence parameters, and the imaging planes for investigation of flow void. Childs Nerv Syst 27:127–135

    Article  PubMed  Google Scholar 

  6. Dincer A, Kohan S, Ozek MM (2009) Is all “communicating” hydrocephalus really communicating? Prospective study on the value of 3D-constructive interference in steady state sequence at 3 T. AJNR Am J Neuroradiol 30:1898–1906

    Article  PubMed  CAS  Google Scholar 

  7. Doll A, Christmann D, Kehrli P, Abu Eid M, Gillis C, Bogorin A, Thiebaut A, Dietemann JL (2000) Contribution of 3D CISS MRI for pre- and post-therapeutic monitoring of obstructive hydrocephalus. J Neuroradiol 27:218–225

    PubMed  CAS  Google Scholar 

  8. Drayer BP, Rosenbaum AE, Reigel DB, Bank WO, Deeb ZL (1977) Metrizamide computed tomography cisternography: pediatric applications. Radiology 124:349–357

    PubMed  CAS  Google Scholar 

  9. Greitz D (2004) Radiological assessment of hydrocephalus: new theories and implications for therapy. Neurosurg Rev 27:145–165, discussion 166–147

    PubMed  Google Scholar 

  10. Guillaume DJ (2010) Minimally invasive neurosurgery for cerebrospinal fluid disorders. Neurosurg Clin N Am 21:653–672, vii

    Google Scholar 

  11. James AE Jr, New PF, Heinz ER, Hodges FJ, DeLand FH (1972) A cisternographic classification of hydrocephalus. Am J Roentgenol Radium Ther Nucl Med 115:39–49

    PubMed  Google Scholar 

  12. Kim DS, Choi JU, Huh R, Yun PH, Kim DI (1999) Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus. Childs Nerv Syst 15:461–467

    Article  PubMed  CAS  Google Scholar 

  13. Kurihara N, Takahashi S, Tamura H, Higano S, Furuta S, Jokura H, Umetsu A (2000) Investigation of hydrocephalus with three-dimensional constructive interference in steady state MRI. Neuroradiology 42:634–638

    Article  PubMed  CAS  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  PubMed  CAS  Google Scholar 

  15. Oertel JM, Mondorf Y, Schroeder HW, Gaab MR (2010) Endoscopic diagnosis and treatment of far distal obstructive hydrocephalus. Acta Neurochir (Wien) 152:229–240

    Article  Google Scholar 

  16. Oi S, Di Rocco C (2006) Proposal of “evolution theory in cerebrospinal fluid dynamics” and minor pathway hydrocephalus in developing immature brain. Childs Nerv Syst 22:662–669

    Article  PubMed  Google Scholar 

  17. Rekate HL (2008) The definition and classification of hydrocephalus: a personal recommendation to stimulate debate. Cerebrospinal Fluid Res 5:2

    Article  PubMed  Google Scholar 

  18. Rekate HL (2009) A contemporary definition and classification of hydrocephalus. Semin Pediatr Neurol 16:9–15

    Article  PubMed  Google Scholar 

  19. Rollins N, Booth T, Shapiro K (2000) The use of gated cine phase contrast and MR venography in achondroplasia. Childs Nerv Syst 16:569–575, discussion 575–567

    Article  PubMed  CAS  Google Scholar 

  20. Stoquart-El Sankari S, Lehmann P, Gondry-Jouet C, Fichten A, Godefroy O, Meyer ME, Baledent O (2009) Phase-contrast MR imaging support for the diagnosis of aqueductal stenosis. AJNR Am J Neuroradiol 30:209–214

    Article  PubMed  CAS  Google Scholar 

  21. Tondreau RL (1985) The retrospectoscope. Egas Moniz 1874–1955. Radiographics 5:994–997

    PubMed  CAS  Google Scholar 

  22. van Lindert EJ, Beems T, Grotenhuis JA (2006) The role of different imaging modalities: is MRI a conditio sine qua non for ETV? Childs Nerv Syst 22:1529–1536

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Acibadem University, Inonu Cad. Okur Sok. No:21, Kozyatagı, Istanbul, 34742, Turkey

    Alp Dinçer

  2. Division of Pediatric Neurosurgery, School of Medicine, Acibadem University, Inonu Cad. Okur Sok. No:21, Kozyatagı, Istanbul, 34742, Turkey

    M. Memet Özek

  3. Department of Radiology, Acibadem Kozyatagi Hospital, Inonu Cad. Okur Sok. No:21, Kozyatagı, Istanbul, 34742, Turkey

    Alp Dinçer

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  1. Alp Dinçer
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Correspondence to Alp Dinçer.

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Dinçer, A., Özek, M.M. Radiologic evaluation of pediatric hydrocephalus. Childs Nerv Syst 27, 1543–1562 (2011). https://doi.org/10.1007/s00381-011-1559-x

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  • DOI: https://doi.org/10.1007/s00381-011-1559-x

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