Jang Sung-Ho, Cho Min-Jye
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu 42415, Korea.
Diagnostics (Basel). 2022 May 25;12(6):1314. doi: 10.3390/diagnostics12061314.
Hydrocephalus is a dilatation of the brain ventricular system by the accumulation of cerebrospinal fluid within the ventricle caused by impaired cerebrospinal fluid circulation or clearance. A diagnosis of hydrocephalus at the chronic stage of stroke has been mainly made by clinical features and radiologic findings on brain computed tomography and magnetic resonance imaging. On the other hand, it could not determine the effect of hydrocephalus or shunt effect on the periventricular neural structures. By contrast, these effects on the periventricular neural structures can be estimated using diffusion tensor imaging (DTI). This article reviewed 10 DTI-based studies related to the diagnosis and estimation of the shunt effect for hydrocephalus in stroke patients. These studies suggest that DTI could be a useful diagnostic and estimation tool of the shunt effect for hydrocephalus in stroke patients. In particular, some studies suggested that fractional anisotropy value in the periventricular white matter could be a diagnostic biomarker for hydrocephalus. As a result, the role of DTI in diagnosing and estimating the shunt effect for hydrocephalus in stroke patients appears to be promising. However, the number of studies and patients of all reviewed studies were limited (10 studies including a total of 58 stroke patients with heterogenous brain pathologies).
脑积水是指由于脑脊液循环或清除受损，导致脑室内脑脊液积聚，从而引起脑室系统扩张。中风慢性期脑积水的诊断主要依据临床特征以及脑部计算机断层扫描和磁共振成像的影像学表现。另一方面，它无法确定脑积水或分流对脑室周围神经结构的影响。相比之下，使用扩散张量成像（DTI）可以评估这些对脑室周围神经结构的影响。本文回顾了10项基于DTI的研究，这些研究与中风患者脑积水的诊断和分流效果评估有关。这些研究表明，DTI可能是中风患者脑积水分流效果的一种有用的诊断和评估工具。特别是，一些研究表明脑室周围白质的分数各向异性值可能是脑积水的诊断生物标志物。因此，DTI在中风患者脑积水的诊断和分流效果评估中的作用似乎很有前景。然而，所有综述研究的数量和患者数量都有限（10项研究，共包括58例患有不同脑部病变的中风患者）。
