Department of Neuroradiology, Hôpital Roger Salengro, Lille, France,
Eur Radiol. 2014 Jan;24(1):136-42. doi: 10.1007/s00330-013-2990-z. Epub 2013 Aug 27.
To develop automated deformation modelling for the assessment of cerebrospinal fluid (CSF) local volume changes in patients with hydrocephalus treated by surgery.
Ventricular and subarachnoid CSF volume changes were mapped by calculating the Jacobian determinant of the deformation fields obtained after non-linear registration of pre- and postoperative images. A total of 31 consecutive patients, 15 with communicating hydrocephalus (CH) and 16 with non-communicating hydrocephalus (NCH), were investigated before and after surgery using a 3D SPACE (sampling perfection with application optimised contrast using different flip-angle evolution) sequence. Two readers assessed CSF volume changes using 3D colour-encoded maps. The Evans index and postoperative volume changes of the lateral ventricles and sylvian fissures were quantified and statistically compared.
Before surgery, sylvian fissure and brain ventricle volume differed significantly between CH and NCH (P = 0.001 and P = 0.025, respectively). After surgery, 3D colour-encoded maps allowed for the visual recognition of the CSF volume changes in all patients. The amounts of ventricle volume loss of CH and NCH patients were not significantly different (P = 0.30), whereas readjustment of the sylvian fissure volume was conflicting in CH and NCH patients (P < 0.001). The Evans index correlated with ventricle volume in NCH patients.
3D mapping of CSF volume changes is feasible providing a quantitative follow-up of patients with hydrocephalus.
• MRI can provide helpful information about cerebrospinal fluid volumes. • 3D CSF mapping allows quantitative follow-up in communicating and non-communicating hydrocephalus. • Following intervention, fissures and cisterns readjust in both forms of hydrocephalus. • These findings support the hypothesis of suprasylvian block in communicating hydrocephalus. • 3D mapping may improve shunt dysfunction detection and guide valve pressure settings.
开发自动变形建模，以评估手术治疗的脑积水患者的脑脊液（CSF）局部容积变化。
通过计算非线性配准前后图像得到的变形场的雅可比行列式，映射出脑室和蛛网膜下腔 CSF 容积变化。共对 31 例连续患者（15 例交通性脑积水（CH）和 16 例非交通性脑积水（NCH））进行了术前和术后研究，使用 3D SPACE（采用不同翻转角演化的应用优化对比采样完善）序列。两名读者使用 3D 彩色编码图评估 CSF 体积变化。量化并统计比较了 Evans 指数和侧脑室和大脑外侧裂术后体积变化。
术前，CH 和 NCH 的大脑外侧裂和脑室内容积差异有统计学意义（P=0.001 和 P=0.025）。手术后，3D 彩色编码图可使所有患者都能识别 CSF 体积变化。CH 和 NCH 患者的脑室体积损失量无显着差异（P=0.30），而 CH 和 NCH 患者的大脑外侧裂体积调整存在冲突（P<0.001）。Evans 指数与 NCH 患者的脑室容积相关。
CSF 体积变化的 3D 映射是可行的，可为脑积水患者提供定量随访。
• MRI 可提供有关脑脊液体积的有用信息。• 3D CSF 映射允许对交通性和非交通性脑积水进行定量随访。• 干预后，两种类型的脑积水的裂隙和脑池都进行了调整。• 这些发现支持交通性脑积水中存在额上腔阻塞的假说。• 3D 映射可以改善分流管功能障碍的检测并指导阀门压力设置。
