O'Hayon B B, Drake J M, Ossip M G, Tuli S, Clarke M
Division of Neurosurgery, Hospital for Sick Children, Toronto, Ont., Canada.
Pediatr Neurosurg. 1998 Nov;29(5):245-9. doi: 10.1159/000028730.
Measurement of ventricular size is important in pediatric patients with hydrocephalus, especially those who are being followed with cerebrospinal fluid (CSF) shunts. While volumetric techniques are a more accurate estimate of true ventricular volume, they are often impracticable when multiple modalities including ultrasound are used. Volumetric area and linear measurements were compared to find the most reasonable measurement method.
Sixty-four computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) scans from 25 children aged 0-17 years with hydrocephalus, before and after treatment, were measured. Measurements included ventricular volume, a ventricular/brain ratio, and four standard linear measures (Evans' ratio, Huckman's measurement, minimal lateral ventricular width, and lateral ventricular span at the body). We also included a new ratio, which accounts for often disproportionate occipital horn expansion in pediatric patients, called the frontal and occipital horn ratio. Volume and linear measurements were compared using the Spearman's correlation coefficients and correlations were further differentiated using a Z test statistic. The frontal and occipital horn ratio was also measured on CT, MRI, and US scans from 44 normal children aged 0-17 years to identify normal values. The effect of age was determined by linear regression.
The best linear correlation with ventricular size was the frontal + occipital horn ratio (r = 0.852) and was equivalent to the ventricular/brain ratio (r = 0.891), previously shown to have the highest correlation with ventricular volume. Evans' ratio correlates less well (r = 0.423). The normal frontal and occipital horn ratio is 0.37 and is independent of age.
The frontal and occipital horn ratio is a simple method of evaluating ventricular size in pediatric hydrocephalus patients with CSF shunts.
测量脑室大小对于患有脑积水的儿科患者很重要，尤其是那些接受脑脊液（CSF）分流术随访的患者。虽然容积技术能更准确地估计真实脑室容积，但当使用包括超声在内的多种检查方法时，它们往往不实用。比较容积面积和线性测量方法以找到最合理的测量方法。
对25名年龄在0至17岁的脑积水儿童在治疗前后进行了64次计算机断层扫描（CT）、磁共振成像（MRI）和超声（US）扫描测量。测量包括脑室容积、脑室/脑比率以及四项标准线性测量指标（埃文斯比率、胡克曼测量值、最小侧脑室宽度和体部侧脑室跨度）。我们还纳入了一个新的比率，该比率考虑了儿科患者中枕角通常不成比例的扩张情况，称为额角与枕角比率。使用斯皮尔曼相关系数比较容积和线性测量值，并使用Z检验统计量进一步区分相关性。还对44名年龄在0至17岁的正常儿童进行了CT、MRI和US扫描测量额角与枕角比率，以确定正常值。通过线性回归确定年龄的影响。
与脑室大小最佳的线性相关性是额角 + 枕角比率（r = 0.852），且与脑室/脑比率相当（r = 0.891），先前已证明该比率与脑室容积的相关性最高。埃文斯比率的相关性较差（r = 0.423）。正常的额角与枕角比率为0.37，且与年龄无关。
额角与枕角比率是评估患有CSF分流术的儿科脑积水患者脑室大小的一种简单方法。
