• Fatma Elkafrawy, Ihab Reda, Mohamed Elsirafy, Mohamed Saied Abdel Gawad, Alaa Elnaggar, and Khalek Abdel Razek Ahmed Abdel AA Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt. Electronic address: arazek@mans.edu.eg..
• Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt.
• World Neurosurg. 2017 Feb 1; 98: 296-302.

ObjectiveTo evaluate the role of three-dimensional constructive interference in steady state (3D-CISS) sequences and phase-contrast magnetic resonance imaging (PC-MRI) in patients with arrested hydrocephalus.MethodsA prospective study of 20 patients with arrested hydrocephalus was carried out. All patients underwent PC-MRI and 3D-CISS for assessment of the aqueduct. Axial (through-plane), sagittal (in-plane) PC-MRI, and sagittal 3D-CISS were applied to assess the cerebral aqueduct and the spontaneous third ventriculostomy if present. Aqueductal patency was graded using 3D-CISS and PC-MRI. Quantitative analysis of flow through the aqueduct was performed using PC-MRI.ResultsThe causes of obstruction were aqueductal obstruction in 75% (n = 15), third ventricular obstruction in 5% (n = 1), and fourth ventricular obstruction in 20% (n = 4). The cause of arrest of hydrocephalus was spontaneous third ventriculostomy in 65% (n = 13), endoscopic third ventriculostomy in 10% (n = 2), and ventriculoperitoneal shunt in 5% (n = 1), and no cause could be detected in 20% of patients (n = 4). There is a positive correlation (r = 0.80) and moderate agreement (κ = 0.509) of grading with PC-MRI and 3D-CISS sequences. The mean peak systolic velocity of cerebrospinal fluid was 1.86 ± 2.48 cm/second, the stroke volume was 6.43 ± 13.81 μL/cycle, and the mean flow was 0.21 ± 0.32 mL/minute.ConclusionsWe concluded that 3D-CISS and PC-MRI are noninvasive sequences for diagnosis of the level and cause of arrested hydrocephalus.Copyright © 2016 Elsevier Inc. All rights reserved.

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