Quantitative Volumenbestimmungen auf MR-Tomogrammen beim kommunizierenden Hydrozephalus

Abstract

For patients with communicating hydrocephalus the implantation of a cardioventricular shunt is mostly an approved therapy. However, indications are frequently problematic and therefore a shunt operation will not be always successful. The proof of periventricular oedemas in addition to clinical signs seems to be a criterion for an indication for implantation and for the selection of a special valve. With the aid of a newly developed computer programme volume estimation of the ventricular system and the periventricular oedemas has been effected for six patients on T2-weighted MR-tomograms (1.5 tesla). Quotients of the different volumes are correlated with cerebrospinal fluid (CSF) pressure obtained during shunt implantation or lumbar measurement. Distinct indications have been found for a correlation between the volume of the periventricular oedemas and the pressure measurements.

Cerebrospinal fluid and interstitial fluid volume measurements in the human brain at 3T with EPI

“…In the normal human brain, small fractions of CSF diffuse into the brain tissue as CSF and ISF communicate freely (21). Periventricular edema in hydrocephalic brain can be detected by looking for PVH (7) and is the result of an increased compensatory CSF flow into the periventricular WM (22). In NPH, PVH are found in many but not all patients, e.g., Krauss et al (23) reported no PVH in 17.1% of 41 patients with confirmed NPH.…”

“…Tullberg et al (5) reported that especially an irregular type of PVH around the frontal horns diminishes after shunt surgery in contrast to smooth PVH. In most cases hyperintensities are only analyzed for the presence, size, and confluence (6) or by the total volume fraction of periventricular hyperintensities compared to the volume fraction of the brain parenchyma (7).…”