PT  - JOURNAL ARTICLE
AU  - Blitz, A.M.
AU  - Huynh, P.P.
AU  - Bonham, L.W
AU  - Gujar, S.K.
AU  - Sorte, D.E.
AU  - Moghekar, A.
AU  - Luciano, M.G.
AU  - Rigamonti, D.
TI  - High-Resolution MRI for Evaluation of Ventriculostomy Tubes: Assessment of Positioning and Proximal Patency
AID  - 10.3174/ajnr.A6320
DP  - 2020 Jan 01
TA  - American Journal of Neuroradiology
PG  - 57--63
VI  - 41
IP  - 1
4099  - http://www.ajnr.org/content/41/1/57.short
4100  - http://www.ajnr.org/content/41/1/57.full
SO  - Am. J. Neuroradiol.2020 Jan 01; 41
AB  - BACKGROUND AND PURPOSE: Imaging evaluation of ventriculostomy tubes, despite the frequency of malfunction, has remained inadequate due to the absence of a systematic way of assessing the catheter itself. In this retrospective review, we assessed the utility of high-resolution 3D MR imaging techniques, including CISS and volumetric interpolated breath-hold examination sequences, in the evaluation of ventriculostomy catheters.MATERIALS AND METHODS: We performed a retrospective review of 23 clinical MR imaging cases of shunted hydrocephalus spanning a 3-year period, all depicting ventriculostomy catheters. The MR imaging examinations included isotropic CISS and volumetric interpolated breath-hold examination sequences performed with and without contrast. These were independently evaluated by 2 neuroradiologists with respect to the catheter course, side hole position, relationship of the side holes to the ventricles, patency, and the presence or absence of intraluminal debris.RESULTS: The catheter tip was best seen on isotropic CISS sequences reformatted in an oblique plane, and side holes were visualized as CSF signal defects along the catheter wall in 10/23 (43%) cases. The relationship of the catheter side holes to the ventricles was seen in 47% of cases and was best visualized on the coronal CISS sequences. Catheter patency was confirmed in 12/23 (52%) cases, while the other 48% were notable for T2 hypointense filling defects compatible with luminal obstruction. Enhancement of some of these filling defects on imaging is suggestive of choroid plexus ingrowth rather than debris.CONCLUSIONS: High-resolution 3D MR imaging using isotropic CISS sequences allows systematic evaluation of catheter positioning, patency, and potential etiologic differentiation of filling defects when shunt dysfunction is suspected.VIBEvolumetric interpolated breath-hold examination