Clinical Significance of Preoperative Cine Magnetic Resonance Study in Communicating Hydrocephalus

ABSTRACT

OBJECTIVE: To evaluate the changes of intracranial cerebrospinal fluid(CSF) dynamics in communicating hydrocephalus, the authors present an analysis of various parameters of cine magnetic resonance(MR) CSF flow images in case of progressive communicating hydrocephalus. METHODS: The MR images were obtained with 1.5T(GE Signa, GE Medical Systems, Milwaukee, USA) unit using the 2 dimensional cine phase contrast sequence with cardiac gating and gradient recalled echo imaging in 10 communicating hydrocephalus and 10 controls. Various parameters of the aqueduct and cervicomedullary subarachnoid space were plotted as wave forms. The wave forms were analyzed for configurations, amplitude parameters(Vmax, Vmin, Vdif), and temporal parameters(R-MSV, R-D, R-MDV, R-S). The statistical significance of each parameter examined with paired t-test. RESULTS: Distinct reproducible configuration features were obtained at both ROIs. We could determine the statistically significant differences between control and communicating hydrocephalus in temporal parameters at the aqueduct level. There was no significant differences at the cervicomedullary subarachnoid space level. In communicating hydrocephalus, the graph showed R-MDV(p=0.005) and R-S(p=0.001) shortening at the aqueduct. CONCLUSION: The analysis of cine MR CSF flow study may be helpful for diagnosing the communicating hydrocephalus and even deciding the necessity of shunting procedures. The temporal parameters are more important than amplitude parameters for diagnosing communicating hydrocephalus.