الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hydrocephalus is a pathology in which the impaired balance between the production and absorption of cerebrospinal fluid results in a dilatation of the intracranial fluid pathways, primarily the ventricular system. Hydrocephalus may be communicating or non-communicating (obstructive).
Arrested hydrocephalus is a form of hydrocephalus in which there is ventriculomegaly with no active periventricular transependymal permeation. It may result from presence of a communication between the ventricular system and the subarachnoid space due to rupture of the thin ventricular wall in response to long standing obstructive hydrocephalus (spontaneous ventriculostomy). It has been reported at various sites, including the floor of the third ventricle, the atrium of the lateral ventricle, and the suprapineal recess.
3D-CISS is a gradient-echo imaging technique with high CSF-to-aqueduct contrast. It provides anatomical information about morphology relationships of aqueduct before surgery. It can be used to discriminate between communicating and non communicating hydrocephalus, to provide significant information in pre-operative evaluation of Chiari 1 malformation, normal pressure hydrocephalus and postoperative follow-up of patients with endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS). It also can assess the presence of STV.
The cine sequences of PC-MRI with cardiac synchronism allow quantifying the CSF flow during a cardiac cycle. Flow measurement with PC-MRI is accurate and reproducible. With flow sensitive PC cine MR imaging, the obstructed CSF wave could be identified across the aqueduct and across the STV if present.
This study was carried out to demonstrate the role of PC-MRI in evaluation of cases with arrested hydrocephalus and searching for the presence of STV as a cause of arrest. It was carried out on 20 patients (of both sexes and different ages) referred to Alexandria Main University Hospital in the period between April 2012 and October 2013.
All patients were subjected to the following:
I. Thorough history taking: including clinical manifestations, operative data and any contraindications for the MRI study.
II. Conventional MRI: The examinations were carried out on a 1.5 Tesla MR System (on Magnetom Avanto, Siemens Medical Solutions). The following conventional MRI sequences were done:
1. Axial and sagittal T1 weighted spin echo.
2. Axial, coronal T2 weighted turbo spin echo (T2 TSE).
3. Axial FLAIR.
III. Thin cuts midline sagittal 3D-CISS images (0.6mm): It was used to allow better visualization of the aqueduct and application of Cine PC-MRI imaging planes perpendicular to it.
IV. Cine PC-MR imaging (in plane and through plane gradient echo sequences).
Measurements were done using retrospective peripherally-gated PC cine MRI.
V. The grading of the aqueductal patency was done in all cases using the following grading systems:
a. Grading of aqueductal patency by 3D-CISS Five patients were graded as grade 0, 3 patients as grade 1 and 12 patients as grade 2.
b. Grading of aqueductal patency by PC-MRI: Five patients were graded as grade 0, 10 patients as grade 1 and 5 patients as grade 2.