Feasibility of 3-dimensional sampling perfection with application optimized contrast sequence in the evaluation of patients with hydrocephalus

Abstract

Purpose: This study aimed to investigate the effectiveness and additive value of T2W 3-dimensional sampling perfection with application optimized contrast (3D-SPACE) with variant flip-angle mode in imaging of all types of hydrocephalus. Our secondary objective was to assess the reliability of 3D-SPACE sequence and correspondence of the results with phase-contrast magnetic resonance imaging (PC-MRI)-based data.Materials and Methods: Forty-one patients with hydrocephalus have undergone 3-T MRI. T2W 3D-SPACE sequence has been obtained in addition to routine hydrocephalus protocol. Cerebrospinal fluid circulation, presence/type/etiology of hydrocephalus, obstruction level scores, and diagnostic levels of confidence were evaluated separately by 2 radiologists. In the first session, routine sequences with PC-MRI were evaluated, and in another session, only 3D-SPACE and 3-dimensional magnetization prepared rapid acquisition gradient echo sequences were evaluated. Results obtained in these sessions were compared with each other and those obtained in consensus session.Results: Agreement values were very good for both 3D-SPACE and PC-MRI sequences (P < 0.001 for all). Also, the correlation of more experienced reader's 3D-SPACE-based scores and consensus-based scores was perfect (kappa = 1, P < 0.001). The mean value of PC-MRI-based confidence scores were lower than those obtained in 3D-SPACE and consensus sessions.Conclusions: T2W3D-SPACE sequence providesmorphologic cerebrospinal fluid flow data. It is a noninvasive technique providing extensive multiplanar reformatted images with a lower specific absorption rate. These advantages over PC-MRI make 3D-SPACE sequence a promising tool in management of patients with hydrocephalus.