Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Evaluation of Aqueductal Patency in Patients with Hydrocephalus: Three-Dimensional High-Sampling-Efficiency Technique (SPACE) versus Two-Dimensional Turbo Spin Echo at 3 Tesla

  • Ucar, Murat (Department of Radiology, School of Medicine, Gazi University) ;
  • Guryildirim, Melike (Department of Radiology, School of Medicine, Gazi University) ;
  • Tokgoz, Nil (Department of Radiology, School of Medicine, Gazi University) ;
  • Kilic, Koray (Department of Radiology, School of Medicine, Gazi University) ;
  • Borcek, Alp (Department of Neurosurgery, School of Medicine, Gazi University) ;
  • Oner, Yusuf (Department of Radiology, School of Medicine, Gazi University) ;
  • Akkan, Koray (Department of Radiology, School of Medicine, Gazi University) ;
  • Tali, Turgut (Department of Radiology, School of Medicine, Gazi University)
  • Received : 2013.12.16
  • Accepted : 2014.08.19
  • Published : 2014.12.01
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Abstract

Objective: To compare the accuracy of diagnosing aqueductal patency and image quality between high spatial resolution three-dimensional (3D) high-sampling-efficiency technique (sampling perfection with application optimized contrast using different flip angle evolutions [SPACE]) and T2-weighted (T2W) two-dimensional (2D) turbo spin echo (TSE) at 3-T in patients with hydrocephalus. Materials and Methods: This retrospective study included 99 patients diagnosed with hydrocephalus. T2W 3D-SPACE was added to the routine sequences which consisted of T2W 2D-TSE, 3D-constructive interference steady state (CISS), and cine phase-contrast MRI (PC-MRI). Two radiologists evaluated independently the patency of cerebral aqueduct and image quality on the T2W 2D-TSE and T2W 3D-SPACE. PC-MRI and 3D-CISS were used as the reference for aqueductal patency and image quality, respectively. Inter-observer agreement was calculated using kappa statistics. Results: The evaluation of the aqueductal patency by T2W 3D-SPACE and T2W 2D-TSE were in agreement with PC-MRI in 100% (99/99; sensitivity, 100% [83/83]; specificity, 100% [16/16]) and 83.8% (83/99; sensitivity, 100% [67/83]; specificity, 100% [16/16]), respectively (p < 0.001). No significant difference in image quality between T2W 2D-TSE and T2W 3D-SPACE (p = 0.056) occurred. The kappa values for inter-observer agreement were 0.714 for T2W 2D-TSE and 0.899 for T2W 3D-SPACE. Conclusion: Three-dimensional-SPACE is superior to 2D-TSE for the evaluation of aqueductal patency in hydrocephalus. T2W 3D-SPACE may hold promise as a highly accurate alternative treatment to PC-MRI for the physiological and morphological evaluation of aqueductal patency.

Keywords

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