Frontal and Temporal Horn Ratio: A Valid and Reliable Index to Determine Ventricular Size in Paediatric Hydrocephalus Pa
Because there is currently no sufficient and prevalent parameter for estimating ventricular size in paediatric hydrocephalus patients by using cranial ultrasound, a new measurement index, called the “frontal and temporal horn ratio”, is presented in this
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Abstract Because there is currently no sufficient and prevalent parameter for estimating ventricular size in paediatric hydrocephalus patients by using cranial ultrasound, a new measurement index, called the “frontal and temporal horn ratio”, is presented in this study. The advantage of the new quotient is that it can be detected in easily obtainable coronal ultrasound planes. A retrospective analysis of 149 MRIs of young hydrocephalus patients proved the new index to be a promising parameter of ventricular size assessment. Statistical comparison between the “frontal and temporal horn ratio” and the already validated “frontal and occipital horn ratio” revealed a strong and linear correlation between the two quotients. Current research is now evaluating the reliability of the new index in the context of an ultrasound study; first results indicate similar positive findings. Keywords Ultrasound • Hydrocephalus • Ventricular size • Linear measurement • Frontal and occipital horn ratio
developed [1, 8, 11]. Instead, different two-dimensional linear parameters, which had been proven to be valid and reliable indices in determining ventricular size (e.g. Evans index, Huckman number, frontal and occipital horn ratio etc.), have become standard for these purposes [7, 8, 11, 12]. As almost all the parameters described require absolute axial slices of the brain, computed tomography (CT) and magnetic resonance imaging (MRI) are usually performed. However, if the patient belongs to the paediatric population, cranial ultrasound (cUS) is the primary method used to evaluate the brain [3, 6, 9, 10, 13–15]. If standard anterior fontanelle imaging is performed, coronal and sagittal slices of the brain can be detected for neurological investigations [3, 9, 10, 13]. This fact implies that the determination of the abovementioned quotients is hardly feasible. Therefore, a new two-dimensional index, called the “frontal and temporal horn ratio”, which can be measured in easily obtainable coronal slices of the infant brain, is recommended.
Introduction
Materials and Methods
The assessment of the ventricular system in hydrocephalus patients is of high clinical importance [1, 6, 12], especially for timely detection of typical shunt complications (e.g. overdrainage, underdrainage, subdural haematoma etc.). Volumetric measurements – which can be performed using different imaging methods – provide the most accurate estimate of true ventricular volume [1, 2, 4, 11, 12]. However, appropriate volumetric techniques are not widely used in clinical routine because a simple and user-friendly method has not yet been
One hundred and forty-nine MRIs (Siemens Sonata, 1.5 T) of 61 hydrocephalus patients (35 male, 26 female) aged 0–11 years (average: 3.1 ± 3.0 years) were retrospectively analysed. The aetiology of hydrocephalic ventricle configuration had been Chiari II malformation (33%), intraventricular haemorrhage (25%), congenital cerebral malformations such as the Dandy–Walker complex or schizencephaly (20%), congenital aqueductal stenosis (10%), o
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