Role of magnetic resonance ventriculography in multiloculated hydrocephalus

Gurpreet S. Gandhoke, Paolo Frass Anito, Nagesh Chandra, Bal K. Ojha, Anoop Singh

Research output: Contribution to journalArticlepeer-review

Abstract

Object. In this paper the authors' goal was to investigate the clinical usefulness of Gd-enhanced MR ventriculography (MRV) in pediatric patients affected by multiloculated hydrocephalus. Methods. Eighteen patients (11 boys and 7 girls, age range 2-14 months) with a diagnosis of multiloculated hydrocephalus were included in the study. After injection of gadodiamide (0.02-0.04 mmol) into the lateral ventricle by tapping the anterior fontanel, sagittal, coronal, and axial T1-weighted MR images were acquired. The location of the septations and the sites of obstruction of CSF flow were assessed. Postoperative MRV was obtained to confirm the results of endoscopic treatment in most complex cases. Results. No adverse events were observed after injection of contrast medium into the ventricular system. Preoperative MRV accurately defined the exact morphology of septae and ventricular walls in all cases. In 1 case the diagnosis of multiloculated hydrocephalus was ruled out. Sites of obstruction of CSF flow within the ventricular system were also well established. In 4 cases the multiple compartments were proven to intercommunicate. Postoperative MRV was useful in assessing the functional status of third ventriculostomy, aqueductoplasty, and other endoscopic fenestrations. Conclusions. Magnetic resonance ventriculography is a safe, effective, and reliable technique. The accurate definition of the anatomy of the ventricles and the site of obstruction in multiloculated hydrocephalus can help to plan the most appropriate treatment and minimize the number of procedures. Although MRV is also useful during postoperative follow-up to determine the results of endoscopic treatment, it should be limited to particularly complex cases, due to its invasiveness.

Original languageEnglish
Pages (from-to)697-703
Number of pages7
JournalJournal of Neurosurgery: Pediatrics
Volume11
Issue number6
DOIs
Publication statusPublished - Jun 2013

Keywords

  • Cerebrospinal fluid flow
  • Endoscopic third ventriculostomy
  • Intrathecal gadolinium
  • Magentic resonance ventriculography
  • Multiloculated hydrocephalus
  • Ventriculogram

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Pediatrics, Perinatology, and Child Health

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