The influence of lumbar spinal drainage on diffusion parameters in patients with suspected normal pressure hydrocephalus using 3T MRI

Autor: Dominik Fritzsch, Karl-Titus Hoffmann, Michael Scheel, Matthias Preuß, M. Reiss-Zimmermann, Markus Dengl
Rok vydání: 2014
Předmět:
Male
medicine.medical_specialty
Cerebrospinal fluid
Lumbar
Normal pressure hydrocephalus
Image Interpretation
Computer-Assisted
Fractional anisotropy
medicine
Humans
Radiology
Nuclear Medicine and imaging
In patient
ddc:610
Normaldruckhydrozephalus
Magnetresonanztomographie (MRT)
Diffusions-Tensor-Bildgebung
Zerebrospinalflüssigkeit (CSF)
Wirbelsäulen-Drainage
Tap-Test
voxelbasierte Analyse
Aged
Cerebrospinal Fluid
Lumbar Vertebrae
Radiological and Ultrasound Technology
business.industry
Radial diffusivity
General Medicine
Normal pressure hydrocephalus
magnetic resonance imaging (MRI)
diffusion tensor imaging
cerebrospinal fluid (CSF)
spinal drainage
tap test
voxel-based analysis
medicine.disease
Hydrocephalus
Normal Pressure
Hydrocephalus
Diffusion Tensor Imaging
Treatment Outcome
Case-Control Studies
Anisotropy
Drainage
Female
Radiology
business
Diffusion MRI
Zdroj: Acta Radiologica. 55:622-630
ISSN: 1600-0455
0284-1851
DOI: 10.1177/0284185113502334
Popis: Background Normal pressure hydrocephalus (NPH) has been an ongoing and challenging field of research for the past decades because two main issues are still not fully understood: the pathophysiologic mechanisms underlying ventricular enlargement and prediction of outcome after surgery. Purpose To evaluate changes in diffusion tensor imaging (DTI) derived parameters in patients with suspected normal pressure hydrocephalus before and after withdrawal of cerebrospinal fluid (CSF). Material and Methods Twenty-four consecutive patients with clinical and radiological suspicion of NPH and 14 age-matched control subjects were examined with DTI on a clinical 3T scanner. Patients were examined before and 6–36 h after CSF drainage (interval between scans, 5 days). Fifteen patients were finally included in data analysis. Fractional anisotropy (FA) and mean, parallel, and radial diffusivity (MD, PD, RD) were evaluated using a combination of a ROI-based approach and a whole-brain voxel-by-voxel analysis. Results Alteration of DTI parameters in patients with suspected NPH is regionally different. Compared to the control group, we found an elevation of FA in the subcortical white matter (SCWM) and corpus callosum, whereas the other diffusion parameters showed an increase throughout the brain in variable extent. We also found a slight normalization of RD in the SCWM in patients after lumbar drainage. Conclusion Our results show that DWI parameters are regionally dependent and reflect multifactorial (patho-) physiological mechanisms, which need to be interpreted carefully. It seems that improvement of gait is caused by a decrease of interstitial water deposition in the SCWM.
Databáze: OpenAIRE
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