Article Figures & Data
Figures
- Fig 1.
A 23-year-old woman (control). A, Sagittal 3D-SPACE with VFAM image shows a normal aqueduct (grade 0, arrow). B, Thin-section axial reformatted 3D-SPACE with VFAM image demonstrates hypointense flow-void signal intensity consistent with an open aqueduct (arrow). C and D, Sagittal (C) and axial (D) PC-MRI are well-matched with 3D-SPACE sequence results (arrows).
- Fig 2.
A 35-year-old man with partial aqueductal stenosis (patient 12). A, Sagittal T2-weighted image shows a narrowed aqueduct (arrow). B, Sagittal 3D-SPACE with VFAM image clearly demonstrates a prominent hypointense signal intensity in the cerebral aqueduct (arrow). The hypointense signal intensity (also called flow-void sign) on the 3D-SPACE MR image indicates the absence of a complete stenosis. C, Coronal oblique curved reconstructed 3D-SPACE image demonstrates a narrow but open aqueduct (arrow). D and E, Axial (D) and sagittal (E) PC-MRI indicate a narrowed but open aqueduct, consistent with partial aqueductal stenosis (arrows).
- Fig 3.
A 7-year-old boy with a complete aqueductal stenosis and hydrocephalus (patient 1). A, Axial FLAIR image shows a compensated hydrocephalus. B, Sagittal thin-section T1-weighted image demonstrates a narrowed distal aqueduct and a prestenotic aqueductal dilation (arrow). C, Sagittal 3D-SPACE with VFAM MR image shows a restricted hyperintense CSF flow proximal to the stenotic segment, whereas the unrestricted flow of CSF distal to the stenosis appears hypointense (arrow). Sagittal (D and E) and axial (F) PC-MRI shows a complete aqueductal stenosis, consistent with 3D-SPACE images.
- Fig 4.
A 9-year-old boy with complete aqueductal stenosis and neurofibromatosis type 1 (patient 21). A and B, Coronal T2-weighted MR image obtained 2 years ago shows no evidence of hydrocephalus (A), whereas a recent T1-weighted MR image shows a progressive hydrocephalus (B). C, Sagittal PC-MRI obtained at the level of the aqueduct shows absence of aqueductal flow (white arrow). Sagittal PC-MRI shows a flow representing the deep venous system in the posteroinferior part of the aqueduct (black arrow, C). The pulsation secondary to the venous flow in the quadrigeminal cistern can mimic the aqueductal flow. D, Sagittal 3D-SPACE with VFAM MR image clearly demonstrates the venous structures located in the third ventricular outlet–the quadrigeminal cistern (black arrow). This image demonstrates a complete aqueductal stenosis (white arrow, D). E and F, Axial thin-section (1 mm) reformatted images obtained from sagittal 3D-SPACE images (E) show multiple hamartomas (arrows, F).
- Fig 5.
Timing diagram of the 3D-SPACE with different flip angles (3D-SPACE with VFAM). The diagram shows 1 TR of the pulse sequence. The first line shows the variation in the heights of the radio-frequency pulses during the echo-train. Gs is the section-selection gradient, which varies to select different sections in k-space. Gk and Gr are the phase-encoding and readout gradients, respectively. The timing diagram was drawn by John P. Mugler III and modified with his permission.
Tables
No. Sex Age (yr) PC-MRI SPACE Consensus Results EH Additional Illness 1 M 7 2 2 2 Web-synechia NF-1 2 F 61 0 0 0 Idiopathic DWM 3 M 59 0 0 0 Idiopathic DWM 4 M 18 0 0 0 FVOO – 5 F 69 0 0 0 TVAC – 6 F 57 0 0 0 CoH DWM 7 F 63 0 0 0 Idiopathic – 8 M 69 0 0 0 Idiopathic – 9 M 27 2 2 2 Web – 10 F 50 2 2 2 Web – 11 M 40 2 2 2 TG – 12 M 35 1 1 1 TG – 13 M 25 2 2 2 Idiopathic – 14 F 54 0 0 0 FVOO Chiari 1 15 M 62 0 0 0 Idiopathic – 16 F 34 1 2 2 TG – 17 M 24 0 0 0 Idiopathic NF-1 18 M 46 0 0 0 Idiopathic – 19 F 43 2 1 1 Web – 20 M 21 0 0 0 Idiopathic – 21 M 9 2 2 2 Web, gliosis NF-1 -
Note:—DWM indicates Dandy-Walker malformation; FVOO, fourth ventricular outlet obstruction; TVAC, third ventricular arachnoid cyst; CoH, complex hydrocephalus; NF-1, neurofibromatosis type 1; EH, etiology of hydrocephalus; TG, tectal glioma.
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