Ventricular Anatomy Across CT and MRI in Hydrocephalus: A Retrospective Study

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Hydrocephalus involves abnormal cerebrospinal fluid dynamics and ventricular enlargement, posing diagnostic and monitoring challenges in clinical practice.
• Routine neuroimaging faces limitations in applying advanced volumetric techniques for hydrocephalus assessment.
• This study focuses on linear ventricular measurements under varied imaging conditions at a tertiary care center.

Purpose of the Study:

• To evaluate the behavior and cross-modality agreement of linear ventricular measurements in hydrocephalus patients.
• To assess the diagnostic utility of imaging markers for hydrocephalus under routine clinical settings.
• To analyze longitudinal changes and associations with Ventriculoperitoneal (VP) shunt placement.

Main Methods:

• Retrospective observational study of 68 adult hydrocephalus patients.
• Measurement of linear ventricular metrics (Evans index, third-ventricle width) on CT and MRI scans.
• Analysis of CT-MRI agreement, longitudinal changes, and association with VP shunt placement.

Main Results:

• Strong agreement observed between CT and MRI for Evans index (r=0.93) and third-ventricle width (r=0.90).
• Longitudinal analyses showed small ventricular size changes post-intervention with significant inter-individual variability.
• Transependymal cerebrospinal fluid exudation strongly correlated with subsequent VP shunting.

Conclusions:

• Standard linear ventricular parameters demonstrate adequate cross-modality agreement and clinically relevant longitudinal behavior.
• These imaging markers are valuable adjuncts to clinical assessment, though insufficient as standalone predictors.
• The findings support the continued use of readily available linear measurements in hydrocephalus management.