Idrocefalo normoteso: Valutazione comparativa tra studi di dinamica liquorale mediante TC e RM

Abstract

Aim of this study was to evaluate the sensitivity of MR dynamic Bolus Tracking technique versus CT-cysterno graphy in Normal Pressure Hydrocephalus (NPH).

Seven patients (age 64–76 yrs), clinically suspected of NPH, were retrospectively evaluated. They had been submitted to CT-cysternography, MR dynamic Bolus Tracking technique in the acqueduct (cardiac-gated flow direction evaluation by means of 12–16 FFE T2*-w acquisitions per cardiac cycle, on sagittal plane along the acqueduct, with presaturation perpendicular to the acqueduct) and finally to surgical evaluation and subsequent ventriculo-peritoneal shunt.

MR showed in all cases altered cerebrospinal fluid (CSF) dynamics: 5 patients showed CSF reflux in the third ventricle during all cardiac cycle, in 2 patients an increased ejection rate through the acqueduct and into the cisterna magna was found. CT-cysternography showed CSF dynamics alterations only in 4 cases.

MR dynamic Bolus Tracking technique has proven to be more sensitive than CT-cysternography in the evaluation of NPH. Even though this study has to be considered preliminary, we believe that this simple and noninvasive technique should be recommended when NPH is suspected.

Keywords

hydrocephalus cerebrospinal fluid ventriculo-peritoneal shunt

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