| Popis: |
Objective: To investigate the extent to which preoperative CSF flow parameters through the aqueduct of Sylvius predicted persistent postoperative hydrocephalus (PPH) in patients with posterior fossa (PF) tumors after surgery. Methods: Twenty patients with PF tumors were enrolled in this prospective cohort study between June 2016 and June 2018. Imaging studies included conventional computerized tomography (CT) scan, magnetic resonance imaging (MRI) with and without gadolinium contrast and phase contrast (cine) magnetic resonance imaging (PC-cMRI). The authors determined the clinical predictors and anthropometric characteristics that caused PPH. CSF flow parameters through the aqueduct of Sylvius were analyzed among patients. In addition, the CSF flow parameters of various clinical predictors associated with PPH were evaluated. Results: Of the 20 patients, 11 were females, and 9 were males. The mean age of patients was 30.4 ± 16.06. Sixteen patients had PPH, while 4 patients did not (PPH-). The mean aqueductal CSF stroke volume (ACSV) was 4.7 ± 2 (µl/sec), and the mean backflow was 4.8 ± 0.8 (µl/sec). ACSV between PPH + and PPH - groups, were significantly correlated (P = 0.038). However, ACSV between patients with preoperative hydrocephalus and those without preoperative hydrocephalus did not correlate (=0.66). Among other CSF parameters such as peak flow volume (P = 0.211), forward flow volume (P = 0.350), mean flow volume (P = 0.767) and net backward flow volume(P = 0.02), only net backward flow revealed a significant correlation between PPH + and PPH- groups. Metastasis (P = 0.47), tumor location (P = 0.37) and sex (P = 0.92) did not correlate with the need for hydrocephalus treatment. However, the presence of papilledema correlated with the need for hydrocephalus treatment (P = 0.002). Conclusion: Our findings showed that although a decreased ACSV correlated with the occurrence of PPH, the presence of preoperative hydrocephalus before posterior fossa tumor resection did not suggest hydrocephalus will persist in surgery. |
