Diagnostic Performance of Whole-Body Ultra-Low-Dose CT for Detection of Mechanical Ventriculoperitoneal Shunt Complications: A Retrospective Analysis

As a premature infant, a 19-year-old man developed intraventricular hemorrhage grade IV with consecutive posthemorrhagic hydrocephalus and formation of a left frontal intracranial cyst. A cysto-ventriculoperitoneal shunt was implanted during the first months of life. At 19 years of age, the patient was referred to our center because of abdominal pain and local induration around the right abdominal scar. WB-ULD-CT revealed an intraperitoneal position of the distal catheter, however with an intraperitoneal cyst or pseudocyst formation. Front (upper left) and lateral (upper right) views of the 3D reconstruction show looping of the peritoneal catheter. On the axial conformation with 5-mm section thickness, intraperitoneal insertion of the catheter (full arrow) as well as intraperitoneal pseudocyst with incorporated catheter loops (transparent arrows) can be detected.

A 33-year-old woman presented with progressive headache, nausea, and vomiting, indicating a shunt dysfunction. Several shunt revisions were needed during infancy. The 3D reconstruction of the current WD-ULD-CT (right) depicts kinking of the shunt tube at the right clavicle (white arrow) as well a short distal catheter in relation to an adult body size. However, the distal catheter passed through the peritoneum (transparent arrows on axial and coronal reconstructions on the left) and ends intraperitoneally.