Endoscopic third ventriculostomy: Predicting outcome with phase-contrast MR imaging

Stavros M. Stivaros, Deborah Sinclair, Paul A. Bromiley, Jieun Kim, John Thorne, Alan Jackson

    Research output: Contribution to journalArticlepeer-review


    Purpose: To determine whether phase-contrast magnetic resonance (MR) imaging measurements of preoperative cerebral blood and cerebrospinal fluid (CSF) hydrodynamics can be used as a biomarker of response to endoscopic third ventriculostomy (ETV). Materials and Methods: Approval from the local research ethics committee and written informed consent were obtained for this prospective study. Thirteen patients (six female patients, seven male patients; median age, 43 years) with chronic obstructive hydrocephalus, 12 of whom went on to undergo ETV, were imaged with phase-contrast MR imaging at 1.5 T to determine rates of total cerebral blood flow (CBF) and ventriculostomy defect, foramen magnum (FM), and cerebral aqueduct CSF flow. Ten control subjects (10 men; median age, 37 years) were similarly imaged. Correlations between measured values were assessed by means of Pearson correlation coefficients. Measurements were compared between groups with a Mann-Whitney test, and measurements before and after surgical intervention were compared with a Wilcoxon test for paired samples. Results: Rates of CBF (356 mL·min-1 ± 73 [standard deviation] vs 518 mL·min-1 ± 79, P <.001) and CSF flow in the FM (17.62 mL·min-1 ± 13.12 vs 36.35 mL·min-1 ± 8, P <.05) were significantly lower in patients than in control subjects. Conclusion: ETV induces changes in brain volume and CBF that can be predicted by using simple metrics. These pilot results support a formal trial of these techniques in a larger prospective study. © RSNA, 2009.
    Original languageEnglish
    Pages (from-to)825-832
    Number of pages7
    Issue number3
    Publication statusPublished - Sept 2009


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