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

Journal of the Korean Pediatric Society 1992;35(1):9-16.
Published online January 15, 1992.
The Comparision of Brain Computed Tomography and Isotope Cisternography in Communicating Hydrocephalus
Jong Chan Kim1, Hwang Min Kim1, Jae Seung Yang1, Baek Keun Lim1, Chul Hu2, Soon Ki Hong2, Young Hyuk Lee3
1Department of Pediatrics, Yonsei University, Wonju College of Medicine, Wonju, Korea
3Department of Pediatrics, Kon Kuk University, Min Joong Hospital, Seoul, Korea
교통성뇌수종 환아에서 전산화 뇌단층촬영과 방사선동원원소를 이용한 대조조영술의 비교
김종찬1, 김황민1, 양재승1, 임백근1, 허철2, 홍순기2, 이영혁3
1연세대학교 원주의대 소아과학교실
3건국대학교 부속 민중병원 소아과학교실
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).
Key Words: Cerebroventricular index, Ventricular angle, Periventricular lucency, Cisternography


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