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Usefulness of intraoperative magnetic resonance ventriculography during endoscopic third ventriculostomy.
[hydrocephalus with stenosis of the aqueduct of sylvius]
Endoscopic
third
ventriculostomy
(
ETV
)
is
the
preferred
method
for
the
treatment
of
noncommunicating
hydrocephalus
.
The
different
success
rates
of
ETV
indicate
the
difficulties
in
predicting
the
success
of
this
procedure
.
To
show
the
usefulness
of
intraoperative
ventriculography
performed
by
the
low
-field
0
.
15
-
T
magnetic
resonance
imager
Polestar
N
20
during
ETV
.
The
study
was
conducted
in
11
patients
with
noncommunicating
hydrocephalus
caused
by
tumors
or
cysts
of
the
third
ventricle
(
n
=
5
)
,
nontumoral
stenosis
of
the
sylvian
aqueduct
(
n
=
3
)
,
and
fourth
ventricle
outlet
obstruction
(
n
=
3
)
.
Intraoperative
magnetic
resonance
(
iMR
)
ventriculography
was
performed
before
and
after
the
ETV
.
In
each
case
,
iMR-ventriculography
was
a
safe
procedure
and
determined
the
exact
site
of
obstruction
of
cerebrospinal
fluid
flow
.
In
all
cases
,
iMR-ventriculography
performed
after
ETV
showed
with
the
greatest
accuracy
the
patency
of
the
performed
fenestrations
,
demonstrating
in
9
patients
good
flow
of
the
contrast
from
the
third
ventricle
to
the
basal
cisterns
,
restricted
flow
in
1
patient
,
and
no
flow
in
1
patient
.
The
results
of
ventriculography
were
consistent
with
the
postoperative
neurological
status
of
operated-on
patients
.
In
3
patients
,
the
opinion
of
the
surgeons
about
the
patency
of
endoscopic
fenestration
,
based
on
intraoperative
observation
of
the
third
ventricle
floor
,
was
inconsistent
with
the
results
from
iMR-ventriculography
.
Low
-field
iMR-ventriculography
is
a
safe
procedure
that
can
be
successfully
applied
during
ETV
to
determine
the
site
of
obstruction
in
hydrocephalus
and
the
patency
of
performed
ventricle
fenestration
.
Diseases
Validation
Diseases presenting
"noncommunicating hydrocephalus"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
This symptom has already been validated