Poroelastic Mechanical Properties of the Brain Tissue of Normal Pressure Hydrocephalus Patients During Lumbar Drain Treatment Using Intrinsic Actuation MR Elastography.
Acad Radiol
; 28(4): 457-466, 2021 04.
Article
en En
| MEDLINE
| ID: mdl-32331966
RATIONALE AND OBJECTIVES: Hydrocephalus (HC) is caused by accumulating cerebrospinal fluid resulting in enlarged ventricles and neurological symptoms. HC can be treated via a shunt in a subset of patients; identifying which individuals will respond through noninvasive imaging would avoid complications from unsuccessful treatments. This preliminary work is a longitudinal study applying MR Elastography (MRE) to HC patients with a focus on normal pressure hydrocephalus (NPH). MATERIALS AND METHODS: Twenty-two ventriculomegaly patients were imaged and subsequently received a lumbar drain placement for cerebrospinal fluid (CSF) drainage. NPH lumbar drain responders and NPH syndrome nonresponders were categorized by clinical presentation. Displacement images were acquired using intrinsic activation (IA) MRE and poroelastic inversion recovered shear stiffness and hydraulic conductivity values. A stable IA-MRE inversion protocol was developed to produce unique solutions for both recovered properties, independent of initial estimates. RESULTS: Property images showed significantly increased shear modulus (pâ¯=â¯0.003 in periventricular region, pâ¯=â¯0.005 in remaining cerebral tissue) and hydraulic conductivity (pâ¯=â¯0.04 in periventricular region) in ventriculomegaly patients compared to healthy volunteers. Baseline MRE imaging did not detect significant differences between NPH lumbar drain responders and NPH syndrome nonresponders; however, MRE time series analysis demonstrated consistent trends in average poroelastic shear modulus values over the course of the lumbar drain process in responders (initial increase, followed by a later decrease) which did not occur in nonresponders. CONCLUSION: These findings are indicative of acute mechanical changes in the brain resulting from CSF drainage in NPH patients.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diagnóstico por Imagen de Elasticidad
/
Hidrocéfalo Normotenso
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Acad Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2021
Tipo del documento:
Article
Pais de publicación:
Estados Unidos