Normal Pressure Hydrocephalus versus Atrophic Dilatation to Distinguish and Predict the Benefits of Surgical Intervention with a Phase-Contrast MRI Technique

Abstract

AIM:To compare mean cerebrospinal fluid (CSF) volume in the aqueduct by using phase-contrast magnetic resonance imaging for the patients with idiopathic normal pressure hydrocephalus (INPH) and atrophic dilation (AD) to investigate the efficacy of this technique in predicting surgery. MATERIAL and METHODS: The MR images of a total of 80 individuals, consisting of 30 patients considered to have INPH, 20 patients with AD not proportional with cerebral sulci, and 30 control cases without a hydrocephalus clinical picture, were evaluated retrospectively. The minute mean aqueductal CSF flow rates of the three groups were compared using the Kruskall-Wallis analysis of variance, and the inter-group statistical comparisons were made using the Mann-Whitney U test. RESULTS: The mean aqueductal flow rates were 46.56 +/- 25.06 ml/min for the INPH group, 9.28 +/- 4.68 ml/min for the AD group, and 8.68 +/- 3.40 ml/min for the control group. The mean flow rate of the INPH group was significantly higher than those of the control and ADH groups (p < 0.001). CONCLUSION: The mean CSF flow rate may be useful in the diagnosis and differential diagnosis, and the prediction of the potential benefits of surgical intervention for patients considered to have INPH.