MRI ASSESSMENT OF CSF FLOW AND DIAGNOSIS OF NORMAL PRESSURE HYDROCEPHALUS

Background: Normal-pressure Hydrocephalus is a clinical triad of gait disturbance, subcortical dementia, and urinary incontinence in a patient who has communicating hydrocephalus. Objective: To reveal the role of phase-contrast MR imaging in the detection of normal pressure hydrocephalus among patients with ventriculomegaly. Patient and Methods: The study group included 40 patients with ventriculomegaly. Patients were referred to the multiple MRI centers (including Nile Scan Radiology Center and Watani Scan Radiology Center), Radiology Department of AL Mokatam Hospital. The consensus about final diagnosis in the ventriculomegaly group was reached on the light of the typical clinical findings and typical conventional MRI findings. The study was done between January 2018 and June 2020. The study was performed on 1.5 Tesla imager, using pulse -gated, cine-phase-contrast MRI technique and CSF quantification software. Results: This study revealed that the surest phase contrast MRI parameters in predicting normal pressure hydrocephalus was a CSF aqueductal stroke volume greater than 42 μL having a positive predictive value100%. Conclusion: The study yielded considerable information on the physiology of the normal CSF circulation, and in the evaluation of pathological CSF flow dynamics in normal pressure hydrocephalus that provided a better method of selecting those patients with hydrocephalus who gain benefit most from shunt operation.