[Periventricular changes following hydrocephalus: quantitative MR-based assessment of tissue characteristics].

Autor: Turkin AM; Burdenko Neurosurgical Center, Moscow, Russia., Afandiev RM; Burdenko Neurosurgical Center, Moscow, Russia., Melnikova-Pitskhelauri TV; Burdenko Neurosurgical Center, Moscow, Russia., Fadeeva LM; Burdenko Neurosurgical Center, Moscow, Russia., Solozhentseva KD; Burdenko Neurosurgical Center, Moscow, Russia., Pogosbekyan EL; Burdenko Neurosurgical Center, Moscow, Russia., Oshorov AV; Burdenko Neurosurgical Center, Moscow, Russia., Pronin IN; Burdenko Neurosurgical Center, Moscow, Russia.
Jazyk: ruština
Zdroj: Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko [Zh Vopr Neirokhir Im N N Burdenko] 2022; Vol. 86 (4), pp. 41-49.
DOI: 10.17116/neiro20228604141
Abstrakt: Objective: To study tissue characteristics of periventricular white matter in patients with open hydrocephalus using DWI MRI and their correlations with CSF flow parameters.
Material and Methods: MRI was performed in 55 patients (35 women and 20 men) with open normal pressure hydrocephalus, as well as 16 patients with malignant occlusive hydrocephalus and interstitial edema (control group). We determined the correlations between severity of hydrocephalus, periventricular lesions and CSF flow parameters considering MR data. Dimensions of ventricular system were assessed using the Evans' index, periventricular changes - using visual four-level scale with calculation of apparent diffusion coefficient (ADC) and fractional anisotropy coefficient (FA).
Results: Among patients with open hydrocephalus, ACD range for periventricular white matter was 1.57±0.15·10 - 3 mm 2 /s in subgroup of patients without periventricular changes ( n =29) and 1.62±0.11×10 - 3 mm 2 /s in patients with periventricular changes ( n =26). In the control group, mean ADC was 1.76±0.18·10 - 3 mm 2 /s ( p <0.05). In patients with open hydrocephalus, FA coefficient in the areas of periventricular changes was 0.70-0.80, in case of occlusive hydrocephalus - 0.68-0.82. There was a significant relationship between the Evans' index and CSF pulsation velocity amplitude, Evans' index and stroke volume, Evans' index and cerebral aqueduct cross-sectional area in patients with open hydrocephalus. Periventricular changes were pronounced in patients with open hydrocephalus and Evans' index > 0.4 ( p <0.05).
Conclusion: According to MR data, periventricular changes in patients with open hydrocephalus differ from true periventricular interstitial edema following occlusive hydrocephalus. Severity of periventricular changes in patients with open hydrocephalus depends on patient age and width of the ventricles, but does not correlate with CSF flow parameters. In our opinion, periventricular changes are associated with dysfunction of glymphatic system. Further research is required to study the functioning of glymphatic system and related processes.
Databáze: MEDLINE