All issues > Volume 35(1); 1992

Original Article

J Korean Pediatr Soc. 1992;35(1):9-16. Published online January 15, 1992.

The Comparision of Brain Computed Tomography and Isotope Cisternography in Communicating Hydrocephalus

Jong Chan JC Kim¹, Hwang Min HM Kim¹, Jae Seung JS Yang¹, Baek Keun BK Lim¹, Chul C Hu², Soon Ki SK Hong², Young Hyuk YH Lee³

¹Department of Pediatrics, Yonsei University, Wonju College of Medicine, Wonju, Korea
³Department of Pediatrics, Kon Kuk University, Min Joong Hospital, Seoul, Korea

Abstract

Brain computed tomograpy is particularly accurate in defining cerebrospinal fluid (CSF) space because of the relatively great density difference between CSF and brain parenchyma. This noninvasive procedure has very quickly become definitive in the diagnosis of hydrocephalus. However, while the typical clinical and radiological picture of a hydrocephalic patient leaves no doubt as to the need for adequate surgical treatment. In such situations, the dynamic detection of CSF pathway can provide helpful answers as to whether a shunting procedure is necessary. We obtained some results by comparing lateral ventricular indices, ventricular angle, and periventricular lucency on brain computed tomography compared with the grade on cisternography in 26 patients with communicating hydrocephalus. The results were as follows; 1) When grade on cisternography was higher, mean of bifrontal CVI, bicaudate CVI, and Evans index which were measured on brain computed tomogram showed a increasing tendency, but bicaudate CVI only showed a significant increase such as grade I 0.25¡¾0.05, grade II 0.29¡¾0.09, grade III 0.32¡¾0.05, grade IV 0.37¡¾0.06(p<0.05 by ANOVA). 2) When grade on cisternography was higher, mean of ventricular angle which was measured on brain computed tomogram showed a significant decrease such as grade I 33.5゜¡¾2.1゜grade II 45.6゜¡¾12.3゜ grade III 42.7゜¡¾12.3゜ grade IV 25.1゜¡¾13.8゜(p<0.05 by ANOVA). 3) When cisternographic grade was higher, incidence of periventricular lucency which was measured on brain computed tomogram showed a significant increase such as grade I 0.0%, grade II 57.1%, grade III 83.3%, grade IV 100% (p<0.05 by Chi-square). 4) When bicaudate CVI was above 0.3, ventricular angle was below 30゜, and periventricular lucency was noted, it could be a indices what is possible to suspect grade IV on cisternography (p<0.05 by Chi-square).

Keywords :Cerebroventricular index, Ventricular angle, Periventricular lucency, Cisternography