Grégory Kuchcinski1,2, Caroline Jacquiez2, Marc Baroncini3, François Machuron4, Hélène Béhal4, Julien Dumont2, Renaud Lopes1,2, Christine Delmaire1,2, Thibaud Lebouvier5,6, Michel Bottlaender7,8, Regis Bordet1, Luc Defebvre1,5, Jean-Pierre Pruvo1,2, Xavier Leclerc1,2, Jérôme Hodel9. 1. Univ Lille, Inserm, UMR_S 1171 'Degenerative and vascular cognitive disorders', Lille, France. 2. CHU Lille, Department of Neuroradiology, Lille, France. 3. CHU Lille, Department of Neurosurgery, Lille, France. 4. Univ Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de Biostatistiques, Lille, France. 5. CHU Lille, Department of Neurology, Lille, France. 6. Memory Center, DISTALZ, Lille, France. 7. Laboratoire Imagerie Moléculaire In Vivo (IMIV), UMR 1023 Inserm/CEA/Université Paris Sud - ERL 95218 CNRS, CEA/I2BM/Service Hospitalier Frédéric Joliot, Orsay, France. 8. UNIACT, Neurospin, Direction de la Recherche Médicale, CEA, Gif-sur-Yvette, France. 9. Department of Neuroradiology, Hôpital Henri Mondor, Créteil, France.
Abstract
BACKGROUND: Idiopathic normal-pressure hydrocephalus (iNPH) is a treatable cause of gait and cognitive impairment. iNPH should be differentiated from ventriculomegaly secondary to brain atrophy to choose the best therapeutic option (ventriculoperitoneal shunt vs medical management). OBJECTIVE: To determine the diagnostic accuracy of automated sulcal morphometry to differentiate patients with iNPH from patients with ventriculomegaly of neurodegenerative origin. METHODS: Thirty-eight consecutive patients with iNPH (shunt responsive n = 31, nonresponsive n = 7), 35 with vascular cognitive disorder, and 25 age- and sex-matched healthy controls were prospectively included and underwent cognitive evaluation and 3T brain magnetic resonance imaging. Sulcal opening of 10 sulci of interest was retrospectively measured using an automated surface-based approach from the 3-dimensional T1-weighted images. Receiver-operating characteristic curve analyses determined the best parameter to identify iNPH patients. RESULTS: The best parameter to discriminate shunt-responsive iNPH from patients with vascular cognitive disorder and healthy controls was the ratio between calcarine sulcus and cingulate sulcus opening with an area under the curve of 0.94 (95% CI: 0.89, 0.99). A cut-off value of 0.95 provided the highest sensitivity (96.8%) and specificity (83.3%). CONCLUSION: This preliminary study showed that automated sulcal morphometry may help the neurosurgeon to identify iNPH patients and to exclude other causes of ventriculomegaly.
BACKGROUND:Idiopathic normal-pressure hydrocephalus (iNPH) is a treatable cause of gait and cognitive impairment. iNPH should be differentiated from ventriculomegaly secondary to brain atrophy to choose the best therapeutic option (ventriculoperitoneal shunt vs medical management). OBJECTIVE: To determine the diagnostic accuracy of automated sulcal morphometry to differentiate patients with iNPH from patients with ventriculomegaly of neurodegenerative origin. METHODS: Thirty-eight consecutive patients with iNPH (shunt responsive n = 31, nonresponsive n = 7), 35 with vascular cognitive disorder, and 25 age- and sex-matched healthy controls were prospectively included and underwent cognitive evaluation and 3T brain magnetic resonance imaging. Sulcal opening of 10 sulci of interest was retrospectively measured using an automated surface-based approach from the 3-dimensional T1-weighted images. Receiver-operating characteristic curve analyses determined the best parameter to identify iNPH patients. RESULTS: The best parameter to discriminate shunt-responsive iNPH from patients with vascular cognitive disorder and healthy controls was the ratio between calcarine sulcus and cingulate sulcus opening with an area under the curve of 0.94 (95% CI: 0.89, 0.99). A cut-off value of 0.95 provided the highest sensitivity (96.8%) and specificity (83.3%). CONCLUSION: This preliminary study showed that automated sulcal morphometry may help the neurosurgeon to identify iNPH patients and to exclude other causes of ventriculomegaly.
Authors: J F Carlsen; A D L Backlund; C A Mardal; S Taudorf; A V Holst; T N Munch; A E Hansen; S G Hasselbalch Journal: AJNR Am J Neuroradiol Date: 2021-12-30 Impact factor: 3.825
Authors: Alexander Rau; Suam Kim; Shan Yang; Marco Reisert; Elias Kellner; Ikram Eda Duman; Bram Stieltjes; Marc Hohenhaus; Jürgen Beck; Horst Urbach; Karl Egger Journal: Clin Neuroradiol Date: 2021-01-26 Impact factor: 3.649