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Role of Diffusion Tensor Imaging in Diagnosis and Estimation of Shunt Effect for Hydrocephalus in Stroke Patients: A
1Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu 42415, Korea.
Insights
Diffusion tensor imaging (DTI) shows promise for diagnosing hydrocephalus in stroke patients and evaluating shunt effectiveness. DTI may identify periventricular white matter changes, aiding in diagnosis and treatment assessment.
Area of Science:
- Neurology
- Radiology
- Biomedical Engineering
Background:
- Hydrocephalus involves cerebrospinal fluid accumulation, often diagnosed in stroke patients via clinical and imaging methods.
- Current methods struggle to assess the impact of hydrocephalus or shunts on periventricular neural structures.
Purpose of the Study:
- To review studies utilizing diffusion tensor imaging (DTI) for diagnosing hydrocephalus in stroke patients.
- To evaluate DTI's capability in estimating the shunt effect on periventricular neural structures.
Main Methods:
- Systematic review of 10 studies employing DTI for hydrocephalus diagnosis and shunt effect estimation in stroke patients.
- Analysis of DTI metrics, particularly fractional anisotropy in periventricular white matter.
Main Results:
- DTI shows potential as a diagnostic tool for hydrocephalus in stroke.
- Fractional anisotropy in periventricular white matter emerged as a potential diagnostic biomarker.
- DTI may help estimate the effectiveness of shunts in managing hydrocephalus.
Conclusions:
- DTI appears to be a promising tool for diagnosing hydrocephalus and assessing shunt efficacy in stroke patients.
- Further research with larger patient cohorts is needed due to the limited scope of reviewed studies.
Abstract:
Hydrocephalus is a dilatation of the brain ventricular system by the accumulation of cerebrospinal fluid within the ventricle caused by impaired cerebrospinal fluid circulation or clearance. A diagnosis of hydrocephalus at the chronic stage of stroke has been mainly made by clinical features and radiologic findings on brain computed tomography and magnetic resonance imaging. On the other hand, it could not determine the effect of hydrocephalus or shunt effect on the periventricular neural structures. By contrast, these effects on the periventricular neural structures can be estimated using diffusion tensor imaging (DTI). This article reviewed 10 DTI-based studies related to the diagnosis and estimation of the shunt effect for hydrocephalus in stroke patients. These studies suggest that DTI could be a useful diagnostic and estimation tool of the shunt effect for hydrocephalus in stroke patients. In particular, some studies suggested that fractional anisotropy value in the periventricular white matter could be a diagnostic biomarker for hydrocephalus. As a result, the role of DTI in diagnosing and estimating the shunt effect for hydrocephalus in stroke patients appears to be promising. However, the number of studies and patients of all reviewed studies were limited (10 studies including a total of 58 stroke patients with heterogenous brain pathologies).
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