Metrizamide shuntography for evaluation of shunt malfunction in hydrocephalus.

Ventricular shunts were evaluated by a shuntographic technique using metrizamide for the contrast material and delayed spot films and computed tomography (CT) to evaluate shunt function. Thirty hydrocephalic patients were studied who had clinical presentations of shunt malfunction. Fifty-two shuntograms were obtained; most demonstrated the cause of shunt malfunction. No contrast-related complications resulted from the procedure. Diagnostic accuracy was greatly improved by this method, since both anatomic and functional evaluations could be performed. In patients with normal studies, unnecessary surgery was eliminated; in abnormal shuntograms, the duration of surgery and the likelihood of complications were reduced because the surgeons knew the exact anatomic derangements to be corrected.