Utility of Radiologic Variables to Predict the Result of Lumbar Infusion Test in the Diagnosis of Idiopathic Normal Pressure Hydrocephalus
| Autor: | Daniel Pascual-Argente, Alvaro Otero-Rodríguez, Andoni García-Martín, Daniel Angel Arandia-Guzmán, Helena Cruz-Terrón, Maria Cristina Munoz-Martin, Pablo Sousa-Casasnovas |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Gyrus Cinguli Subarachnoid Space Corpus Callosum 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Lumbar Neuroimaging Predictive Value of Tests Humans Medicine Cutoff In patient Cingulate sulcus Aged Retrospective Studies Aged 80 and over Infusion test business.industry Lumbosacral Region Magnetic Resonance Imaging Cerebrospinal Fluid Shunts Hydrocephalus Normal Pressure Temporal Lobe 030220 oncology & carcinogenesis (Idiopathic) normal pressure hydrocephalus Female Surgery Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 127:e957-e964 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2019.04.009 |
| Popis: | Diagnosis of idiopathic normal pressure hydrocephalus is based in clinical data, radiologic variables, and invasive cerebrospinal fluid (CSF) testing, such as the lumbar infusion test. Several neuroimaging findings are inconclusively related to improvement after CSF shunt surgery. CSF tests are invasive and have complications. The aim of this study was to select radiologic variables related to a positive lumbar infusion test so as to avoid this test in patients.Patients with possible idiopathic normal pressure hydrocephalus were reviewed. The collected radiologic data were cingulate sulcus sign, disproportionately enlarged subarachnoid space, callosal angle, and width of temporal horns. Two groups were established: group 1, comprising patients with resistance to CSF outflow12 mm Hg/mL/minute, and group 2, comprising patients with resistance to CSF outflow12 mm Hg/mL/minute. Negative and positive predictive values were determined.The study included 43 patients in group 1 and 64 patients in group 2. Group 2 significantly showed more acute callosal angle with higher accuracy cutoff value of 90.6°, lower width of temporal horns with higher accuracy cutoff value of 8 mm, and higher percentage of cingulate sulcus sign and disproportionately enlarged subarachnoid space. Matching the radiologic variables, positive predictive values were80%; however, negative predictive values were low.Owing to high positive predictive values of matched radiological variables, the lumbar infusion test could be avoided in the diagnosis of idiopathic normal pressure hydrocephalus. However, when 1 or 2 of the variables are negative, this invasive test should be performed. |
| Databáze: | OpenAIRE |
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