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The aqueduct of Sylvius: applied 3-T magnetic resonance imaging anatomy and morphometry with neuroendoscopic relevance.
[hydrocephalus with stenosis of the aqueduct of sylvius]
The
aqueduct
of
Sylvius
(
AqSylv
)
is
a
structure
of
increasing
importance
in
neuroendoscopic
procedures
.
However
,
there
is
currently
no
clear
and
adequate
description
of
the
normal
anatomy
of
the
AqSylv
.
To
study
in
detail
hitherto
unavailable
normal
magnetic
resonance
imaging
morphometry
and
anatomic
variants
of
the
AqSylv
.
We
retrospectively
studied
normal
midsagittal
T
1
-
weighted
3
-
T
magnetic
resonance
images
in
100
patients
.
We
measured
widths
of
the
AqSylv
pars
anterior
,
ampulla
,
and
pars
posterior
;
its
narrowest
point
;
and
its
length
.
We
recorded
angulation
of
the
AqSylv
relative
to
the
third
ventricle
as
multiple
deviations
of
the
long
axis
of
the
AqSylv
from
the
Talairach
bicommissural
line
.
We
statistically
determined
age-
and
sex-related
changes
in
AqSylv
morphometry
using
the
Pearson
correlation
coefficient
.
We
measured
angulation
of
the
AqSylv
relative
to
the
fourth
ventricle
and
correlated
this
to
the
cervicomedullary
angle
(
a
surrogate
for
head
position
)
.
Patients
were
13
to
83
years
of
age
(
45
%
male
,
55
%
female
)
.
Mean
morphometrics
were
as
follows
:
pars
anterior
width
,
1
.
1
mm
;
ampulla
width
,
1
.
2
mm
;
pars
posterior
width
,
1
.
4
mm
;
length
,
14
.
1
mm
;
narrowest
point
,
0
.
9
mm
;
and
angulation
in
relation
to
the
third
and
fourth
ventricles
,
26
°
and
18
°
,
respectively
.
Age
correlated
positively
with
width
and
negatively
with
length
of
the
AqSylv
.
There
was
no
correlation
between
AqSylv
alignment
relative
to
the
foramen
magnum
and
the
cervicomedullary
angle
.
Normative
dimensions
of
the
AqSylv
in
vivo
are
at
variance
with
published
cadaveric
morphometrics
.
The
AqSylv
widens
and
shortens
with
cerebral
involution
.
Awareness
of
these
normal
morphometrics
is
highly
useful
when
stent
placement
is
an
option
during
aqueductoplasty
.
Reported
data
are
valuable
in
guiding
neuroendoscopic
management
of
hydrocephalus
and
aqueductal
stenosis
.
Diseases
Validation
Diseases presenting
"posterior width"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
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