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Radionuclide shuntogram: adjunct to manage hydrocephalic patients
O Vernet1, J P Farmer, R Lambert
1Department of Neurosurgery, Montreal Children's Hospital, McGill University, Québec, Canada.
Summary
Shuntograms are valuable for diagnosing shunt malfunction in children. Key indicators of a normal shuntogram include ventricular reflux, complete visualization of the shunt system, and uniform isotope diffusion, aiding in effective patient management.
Area of Science:
- Pediatric Neurosurgery
- Radiological Imaging
Background:
- Shunt malfunction is a common complication in hydrocephalus management.
- Conventional imaging may not always elucidate shunt issues.
- Shuntograms offer a diagnostic approach for suspected shunt malfunction.
Purpose of the Study:
- To establish technical criteria for optimizing shuntogram reliability.
- To improve the diagnostic accuracy of shuntograms in managing shunt malfunction.
Main Methods:
- Fifty-six shuntograms were performed in 47 children with symptoms of shunt malfunction.
- 0.5 ml 99mTc-DTPA was injected into the shunt reservoir for visualization.
Main Results:
- 22 shuntograms showed ventricular reflux and full visualization; 3 had partial obstruction.
- 15 showed normal proximal reflux but abnormal distal drainage; 10 had distal issues.
- 19 showed no proximal reflux; 12 had obstructed ventricular catheters.
Conclusions:
- Shuntograms are useful for managing shunt-related problems.
- Normal shuntograms require ventricular reflux, full visualization, and uniform diffusion.
- Absence of ventricular reflux suggests proximal obstruction; rapid clearance indicates distal obstruction.