[Radionuclide ventriculography in the diagnosis of hydrocephalus in children]
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Radionuclide cisternography helps differentiate open hydrocephalus from obstructive hydrocephalus. Findings aid in assessing cerebrospinal fluid (CSF) resorption and disease stage.
Area of Science:
- Neurology
- Nuclear Medicine
- Radiology
Background:
- Hydrocephalus is a condition characterized by abnormal accumulation of cerebrospinal fluid (CSF) within the brain's ventricles.
- Differentiating between open and obstructive hydrocephalus is crucial for appropriate management.
- Radionuclide imaging offers a non-invasive method for evaluating CSF dynamics.
Purpose of the Study:
- To establish radiological criteria for differentiating open and obstructive hydrocephalus using 99mDTPA ventriculography and cisternography.
- To assess the utility of radionuclide imaging in evaluating CSF resorption and disease staging in hydrocephalus patients.
Main Methods:
- Ventriculography and cisternography were performed using 99mTechnetium-labeled diethylenetriaminepentaacetic acid (99mDTPA) in 30 patients.
- Radiological findings were analyzed to identify characteristic patterns for different types of hydrocephalus.
- Cerebrospinal fluid (CSF) spaces, including ventricles, cisterns, and subdural spaces, were visualized at preset time intervals.
Main Results:
- Open hydrocephalus signs include visualization of lateral and third/fourth ventricles, great cistern, and cervical subdural space, with absent RPH in cerebral subdural spaces.
- Obstructive hydrocephalus shows visualization of one or two lateral ventricles, the third ventricle, and the great cistern.
- Radionuclide ventriculography revealed CSF disturbances indicative of impaired resorption and decompensated disease stages.
Conclusions:
- Radionuclide cisternography provides distinct radiological signs for differentiating open from obstructive hydrocephalus.
- This imaging technique is valuable for assessing CSF resorption capacity and determining the stage of hydrocephalus.
- Findings support the use of 99mDTPA imaging in the diagnostic workup of hydrocephalus.
Abstract:
Using the findings of ventriculo- and cisternography with 99mDTPA performed in 30 patients, it has been shown that the signs of open hydrocephalus should be considered the following: the visualization of the lateral ventricles, the third and fourth ventricles, the great cistern and the subdural space of the cervical part of the spinal cord (in preset time intervals); RPH complete absence (even after 24 h) in the subdural space of the brain (convencital, medial and parasagittal parts). Significant radiological signs of occlusive hydrocephalus are obtained from the visualization of one or two lateral ventricles; the visualization of the third ventricle and the great cistern. CSF disturbances revealed in radionuclide ventriculography can be used for the assessment of CSF resorption as well as the stage of process (decompensated stage).