Kerscher Susanne R, Schweizer Louise L, Haas-Lude Karin, Bevot Andrea, Schuhmann Martin U
Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
Department of Neurosurgery, University Hospital of Tuebingen, Tübingen, Germany.
Childs Nerv Syst. 2020 Sep;36(9):2033-2039. doi: 10.1007/s00381-020-04570-1. Epub 2020 Mar 25.
In hydrocephalic children, regular investigations of the ventricles are important for initial diagnosis and after initial treatment. Our recent study showed that changes of the third ventricle diameter (TVD) reliably reflect changes of the entire ventricular system at diagnosis and following initial therapy. This study compares changes of TVD with changes of ventricle indices at acute shunt failure and after shunt revision in hydrocephalic children.
A total of 117 children with hydrocephalus were included in this study. MRI/CT images of 30 children were evaluated at the time of acute shunt dysfunction and after subsequent shunt revision. Measurements included axial TVD and three standard measures of lateral ventricles (Evans index, frontal occipital horn ratio (FOHR), and cella media index (CMI)). In 97 children, correlation between axial and coronal/diagonal TVD was evaluated at the time of initial diagnosis of hydrocephalus.
At acute shunt dysfunction, the best linear correlation was found between TVD and CMI (r = 0.702, p < 0.01). Changes of TVD correlated very well to changes of FOHR (r = 0.74, p < 0.01) after shunt revision. The correlation between axial and coronal/diagonal TVD was outstanding (r = 0.995, p < 0.01).
TVD showed a significant correlation with all lateral ventricle indices at acute shunt dysfunction and after shunt revision. It is therefore not only an excellent mirror of ventricular changes at initial hydrocephalus diagnosis and therapy, but it can also reliably reflect changes of the ventricular system in relevant clinical situations associated with the lifelong treatment of pediatric hydrocephalus.
在脑积水患儿中，定期对脑室进行检查对于初始诊断及初始治疗后均很重要。我们最近的研究表明，第三脑室直径（TVD）的变化能够可靠地反映诊断时及初始治疗后整个脑室系统的变化。本研究比较了脑积水患儿急性分流失败时及分流修复后的TVD变化与脑室指数变化。
本研究共纳入117例脑积水患儿。对其中30例患儿在急性分流功能障碍时及随后的分流修复后进行了MRI/CT图像评估。测量指标包括轴位TVD以及侧脑室的三项标准测量指标（埃文斯指数、额枕角比（FOHR）和中脑导水管指数（CMI））。对97例患儿在脑积水初始诊断时评估了轴位与冠状位/斜位TVD之间的相关性。
在急性分流功能障碍时，TVD与CMI之间的线性相关性最佳（r = 0.702，p < 0.01）。分流修复后，TVD的变化与FOHR的变化相关性非常好（r = 0.74，p < 0.01）。轴位与冠状位/斜位TVD之间的相关性非常显著（r = 0.995，p < 0.01）。
在急性分流功能障碍时及分流修复后，TVD与所有侧脑室指数均显示出显著相关性。因此，它不仅是脑积水初始诊断和治疗时脑室变化的良好反映指标，而且在与小儿脑积水终身治疗相关的临床情况下，也能可靠地反映脑室系统的变化。
