Muehlmann M, Steffinger D, Peraud A, Lehner M, Heinen F, Alperin N, Ertl-Wagner B, Koerte IK. [Non-invasive estimation of intracranial pressure : MR-based evaluation in children with hydrocephalus].
Radiologe 2013;
52:827-32. [PMID:
22903585 DOI:
10.1007/s00117-012-2326-z]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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.
PRACTICAL RECOMMENDATIONS
Further studies in larger patient cohorts are warranted to investigate its application in children with hydrocephalus.
Collapse