Use of computed tomography and diffusion weighted imaging in children with ventricular shunt
Use of computed tomography and diffusion weighted imaging in children with ventricular shunt
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DOI：
10.1007/s00381-018-04046-3
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发表时间：
2019-03-01
影响因子：
1.4
通讯作者：
Hanalioglu, Sahin
中科院分区：
文献类型：
--
作者：
Gunes, Altan;Oncel, Ibrahim Halil;Hanalioglu, Sahin
目的评价脑室腹腔分流术患儿的脑计算机断层扫描（CT）和弥散加权成像（DWI）的适应证、数量和影像学结果，估算辐射剂量，并评价DWI的有效性。方法本回顾性研究连续纳入54例因先天异常缺氧而进行分流的患者（男/女=30/24，平均年龄34.1岁）。 2015 年 1 月至 2018 年 3 月期间发生缺血性脑病。使用临床和神经影像学检查结果评估分流相关并发症 (SRC) 的存在，并接受标准参考作为分流修正。使用埃文斯指数以及额角和枕角比率进行脑室大小比较，并使用布兰德-奥尔特曼分析比较观察者进行的每次测量。计算卡帕系数和组内相关系数以评估观察者之间的一致性。结果每名患者的平均入院次数、CT 扫描次数和 DWI 分别为 5.8、4.8 和 1.1。入院与 CT 扫描之间观察到显着的线性相关（r=0.288，p=0.035）。患有SRC的患者的CT扫描次数和每名患者的累积有效剂量高于未患有SRC的患者（p0.05）。观察者之间的埃文斯指数和额枕角比率几乎是完美的（ICC=0.94-0.99，p）
PurposeTo evaluate the indications, number, and imaging results of brain computed tomography (CT) and diffusion weighted imaging (DWI) in children with ventriculoperitoneal shunt, to estimate the radiation dose, and to evaluate the effectiveness of DWI.MethodsThis retrospectively study included 54 consecutive patients (boys/girls = 30/24, mean age, 34.1years) with shunt that were placed due to congenital abnormalities-hypoxic ischemic encephalopathy between January 2015 and March 2018. The presence of shunt-related complications (SRC) was assessed using clinical and neuroimaging findings, and the standard reference was accepted as the shunt revision. Size comparisons of ventricles were performed using Evans index and the frontal and occipital horn ratio, and each measurement made by the observers were compared using Bland-Altman analysis. A kappa coefficient and the intraclass correlation coefficient were calculated to assess the agreement between observers.ResultsThe mean number of hospital admission, number of CT scans, and DWI were 5.8, 4.8, and 1.1, respectively per patient. A significant linear correlation was observed between hospital admission and CT scans (r=0.288, p=0.035). The number of CT scans and the cumulative effective dose per patient were higher in patients with SRC than in those without (p0.05). Inter-observer agreements between observers were almost perfect for the Evans index and the frontal and occipital horn ratio (ICC=0.94-0.99, p