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AJNR - American Journal of Neuroradiology

Published ahead of print on October 2, 2008
doi: 10.3174/ajnr.A1308

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American Journal of Neuroradiology 30:209-214, January 2009
© 2009 American Society of Neuroradiology

BRAIN

Phase-Contrast MR Imaging Support for the Diagnosis of Aqueductal Stenosis

S. Stoquart-El Sankari^a, P. Lehmann^b, C. Gondry-Jouet^b, A. Fichten^c, O. Godefroy^a, M.-E. Meyer^d and O. Baledent^d

^a Department of Neurology, Amiens University Hospital, Amiens Cedex, France
^b Department of Radiology, Amiens University Hospital, Amiens Cedex, France
^c Department of Neurosurgery, Amiens University Hospital, Amiens Cedex, France
^d Department of Imaging and Biophysics, Amiens University Hospital, Amiens Cedex, France

Please address correspondence to Souraya Stoquart-El Sankari, MD, Service de Neurologie, CHU Nord, 80054 Amiens Cedex, France; e-mail: stoquart-elsankari.soraya{at}chu-amiens.fr and Olivier Baledent, PhD, Department of Imaging and Biophysics, CHU Nord, 80054 Amiens Cedex, France; e-mail: olivier.baledent{at}chu-amiens.fr

BACKGROUND AND PURPOSE: Patients with aqueductal stenosis (AS) present with various clinical and radiologic features. Conventional MR imaging provides useful information in AS but depends on a subjective evaluation by the neuroradiologist. The purpose of this study was to evaluate the support of the phase-contrast MR imaging (PC-MR imaging) technique (sensitive to CSF flows) for the diagnosis of AS.

MATERIALS AND METHODS: We retrospectively considered 17 patients who underwent PC-MR imaging to explore hydrocephalus, with the absence of CSF flow at the aqueductal level. We analyzed their clinical and morphologic MR imaging data.

RESULTS: None of the usually reported direct or indirect signs of aqueductal obstruction were seen in 7 patients in whom the clinical suggestion of AS was confirmed by PC-MR imaging results. Seven patients in this population had a third ventriculostomy, and 5 of them were among those in whom conventional MR imaging failed to reveal signs of aqueductal obstruction. All of these 7 patients had a positive postsurgical outcomes. The analysis of CSF and vascular dynamic data in this population was compared with an aged-matched population, and these data were found similar except for the fourth ventricular CSF flush flow latency.

CONCLUSIONS: PC-MR imaging supports the diagnosis of CSF flow blockage at the aqueductal level in a reliable, reproducible, and rapid way, which aids in the diagnosis of AS in patients with clinical and/or radiologic suggestion of obstructive hydrocephalus. We, therefore, suggest using this technique in the current evaluation of hydrocephalus.