Dynamic Magnetic Resonance Imaging of Endoscopic Third Ventriculostomy Patency With Differently Acquired Fast Imaging With Steady-State Precission Sequences

Abstract

The aim of the study was to determine the possibilities of two differently acquired two-dimensional fast imaging with steady-state precession (FISP 2D) magnetic resonance sequences in estimation of the third ventricle floor fenestration patency after endoscopic third ventriculostomy (ETV) in the subjects with aqueductal stenosis/obstruction.Fifty eight subjects (37 males, 21 females, mean age 27 years) with previously successfully performed ETV underwent brain MRI on 1.5T MR imager 3-6 months after the procedure. Two different FISP 2D sequences (one included in the standard vendor provided software package, and the other, experimentally developed by our team) were performed respectively at two fixed slice positions: midsagittal and perpendicular to the ETV fenestration, and displayed in a closed-loop cinematographic format in order to estimate the patency. The ventricular volume reduction has been observed as well.Cerebrospinal fluid (CSF) flow through the ETV fenestration was observed in midsagittal plane with both FISP 2D sequences in 93.11% subjects, while in 6.89% subjects the dynamic CSF flow MRI was inconclusive. In the perpendicular plane CSF flow through the ETV fenestration was visible only by use of experimentally developed FISP 2D (TR30/FA70) sequence. Postoperative volume reduction of lateral and third ventricle was detected in 67.24% subjects.Though both FISP 2D sequences acquired in midsagittal plane may be used to estimate the effects of performed ETV, due to achieved higher CSF pulsatile flow sensitivity, only the use of FISP 2D (TR30/FA70) sequence enables the estimation of the treatment effect in perpendicular plane in the absence of phase-contrast sequences.

Magnetic Resonance Imaging Cerebrospinal Fluid Hydrodynamics in Patients with Meningitis

“…is was evidenced by the reduced aqueductal flow on cine MR images and consistent with the studies by Lucic et al, Parkkola et al, and Abdelhameed et al, wherein reduced aqueductal flow was observed in patients with hydrocephalus as a result of aqueductal stenosis. [19][20][21] is further affirms the role of PCMRI in the differentiation of communicating and non-communicating hydrocephalus.…”

Evaluating the Postoperative Results of Endoscopic Third Ventriculostomy in Triventricular Hydrocephalus by Correlation of Clinical Outcome and Magnetic Resonance Dynamic Cerebrospinal Fluid (CSF) Flowmetry

“…The mean Diameter 3r d ventricle in mm Preoperative was 9.92 (±1.14 SD) with range (7.9-12.4) and the mean Diameter 3 rd ventricle in mm Postoperative was 5.72 (±1.82 SD) with range (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). There was a high statistically significant difference between preoperative and postoperative Diameter 3 rd ventricle in mm, Fig.…”

“…Our results are in agreement with (Qiguang Wang, Jian Ching, Si Zhang, Qiang Li, Xuhui Hui, Yun Ju) as they observed that all the patients underwent ballooning of the floor of the third ventricle, the most common etiologies were brain tumors and aqueduct stenosis. Lucic et al [11] showed "patients included in their study hospitalized for the treatment of obstructive hydrocephalus due to the non-tumorous stenosis/obstruction of cerebral aqueduct". Zohdi et al [12] reported that their patients had obstructive hydrocephalus due to congenital aqueductal stenosis.…”

Simple Identification of Cerebrospinal Fluid Turbulent Motion Using a Dynamic Improved Motion-sensitized Driven-equilibrium Steady-state Free Precession Method Applied to Various Types of Cerebrospinal Fluid Motion Disturbance

“…On T2 that is performed postoperatively with the purpose of observing the ventricles or morphological changes in the cyst, CSF motion through the fenestration is observed as an artifact in addition to morphological information, albeit with mediocre visibility. 20,21) Imaging methods such as phase contrast (PC), [22][23][24] the time-spatial inversion pulse (Time-SLIP) method, 25) and two-dimensional fast imaging with steady-state precession magnetic resonance sequence 26) have been used for post-ETV evaluation as a superior method to visualize CSF motion. The Dynamic iMSDE SSFP method described in this manuscript is superior for visualizing the irregular CSF motions, and our results showed that fenestration of cyst or ventricle with limited CSF motion resulted in clear visualization of recovered CSF motion as a turbulent movement.…”