[Non-invasive estimation of intracranial pressure : MR-based evaluation in children with hydrocephalus]. / Nichtinvasive Bestimmung des intrakraniellen Drucks : MR-basierte Untersuchung bei Kindern mit Hydrozephalus.
Radiologe
; 52(9): 827-32, 2012 Sep.
Article
in De
| MEDLINE
| ID: mdl-22903585
ABSTRACT
CLINICAL/METHODICAL ISSUE The intracranial pressure (ICP) is a crucially important parameter for diagnostic and therapeutic decision-making in patients with hydrocephalus. STANDARD RADIOLOGICAL METHODS:
So far there is no standard method to non-invasively assess the ICP. Various approaches to obtain the ICP semi-invasively or non-invasively are discussed and the clinical application of a magnetic resonance imaging (MRI)-based method to estimate ICP (MR-ICP) is demonstrated in a group of pediatric patients with hydrocephalus. METHODICAL INNOVATIONS Arterial inflow, venous drainage and craniospinal cerebrospinal fluid (CSF) flow were quantified using phase-contrast imaging to derive the MR-ICP. PERFORMANCE A total of 15 patients with hydrocephalus (n=9 treated with shunt placement or ventriculostomy) underwent MRI on a 3 T scanner applying retrospectively-gated cine phase contrast sequences. Of the patients six had clinical symptoms indicating increased ICP (age 2.5-14.61 years, mean 7.4 years) and nine patients had no clinical signs of elevated ICP (age 2.1-15.9 years; mean 9.8 years; all treated with shunt or ventriculostomy). Median MR-ICP in symptomatic patients was 24.5 mmHg (25th percentile 20.4 mmHg; 75th percentile 44.6 mmHg). Median MR-ICP in patients without acute signs of increased ICP was 9.8 mmHg (25th percentile 8.6 mmHg; 75th percentile 11.4 mmHg). Group differences were significant (p < 0.001; Mann-Whitney U-test). ACHIEVEMENTS The MR-ICP technique is a promising non-invasive tool for estimating ICP. PRACTICALRECOMMENDATIONS:
Further studies in larger patient cohorts are warranted to investigate its application in children with hydrocephalus.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Magnetic Resonance Imaging
/
Image Interpretation, Computer-Assisted
/
Intracranial Pressure
/
Hydrocephalus
/
Manometry
Type of study:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
De
Journal:
Radiologe
Year:
2012
Document type:
Article