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Research ArticlePediatric Neuroimaging

Ultrafast Brain MRI Can Be Used for Indications beyond Shunted Hydrocephalus in Pediatric Patients

A. Tekes, S.S. Senglaub, E.S. Ahn, T.A.G.M. Huisman and E.M. Jackson
American Journal of Neuroradiology July 2018, DOI: https://doi.org/10.3174/ajnr.A5724
A. Tekes
aFrom the Department of Radiology (A.T., T.A.G.M.H.), Division of Pediatric Radiology and Pediatric Neuroradiology
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S.S. Senglaub
bDepartment of Neurosurgery (S.S.S., E.S.A., E.M.J.), Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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E.S. Ahn
bDepartment of Neurosurgery (S.S.S., E.S.A., E.M.J.), Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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T.A.G.M. Huisman
aFrom the Department of Radiology (A.T., T.A.G.M.H.), Division of Pediatric Radiology and Pediatric Neuroradiology
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E.M. Jackson
bDepartment of Neurosurgery (S.S.S., E.S.A., E.M.J.), Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • Fig 1.
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    Fig 1.

    UFB-MRI performed in axial (A), sagittal (B), and coronal (C) planes with HASTE in a 1-day-old male infant with natural sleep. The study indication was a prenatal diagnosis of ventriculomegaly. Note the mild enlargement of the supratentorial ventricles and normal size of the fourth ventricle. There were no clinical signs of increased intracranial pressure. Although the cerebral aqueduct patency evaluation was limited in this study, the patient was followed with UFB-MRI. No additional standard MRI was deemed clinically necessary (Fig 2).

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    Fig 2.

    Coronal HASTE of the same patient as in Fig 1 obtained at day of life 1 (A), 5 months of age (B), and 2 years of age (C). Imaging demonstrates normalization of the ventricular size across time. High-quality diagnostic images were obtained without exposure to radiation or sedation/anesthesia. Ventricular size and extra-axial spaces are easily seen in all UFB-MRIs. This case shows the value of UFB-MRI in follow-up examinations in children with ventriculomegaly.

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    Fig 3.

    A 10-year-old girl incidentally found to have hydrocephalus. In this imaging, she is 6 months status post third ventriculostomy. A, Sagittal HASTE in the midline shows lateral ventriculomegaly. Note the CSF flow artifacts/signal loss through the ventriculostomy site (arrow) at the floor of the third ventricle, B, Sagittal CISS at the same plane shows similar findings (arrow) with higher spatial resolution.

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    Fig 4.

    A 3-month-old child with macrocephaly and head circumference increase from the 50th to >95th percentile with normal neurologic developmental milestones. UFB-MRI was performed with axial (A), coronal (B), and sagittal (C) HASTE. Note mild supratentorial ventriculomegaly and prominence of the frontoparietal extra-axial CSF spaces confirming benign enlargement of the extra-axial CSF spaces.

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    Fig 5.

    A 2-month-old boy with a prenatal diagnosis of intracranial cysts. Axial (A), right (B), and left (C) parasagittal HASTE shows simple-appearing cysts at the caudothalamic notches (arrows) without other abnormalities. Note the normal ventricular size. Follow-up MRI at 6 months of age showed resolution of these cysts.

Tables

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  • Patient age and sex distribution per diagnosis

    TotalMaleFemaleAge Range (yr)Age (Mean) (yr)Age (SD) (yr)Age (Median) (yr)5 Years of Age or Younger1 Year of Age or YoungerYounger than 1 Year of Age
    Ventriculomegaly8444400.003–17.633.284.641.0565/84 (77%)57/84 (68%)41/84 (49%)
    Macrocephaly181350.2–4.421.261.090.9818/18 (100%)14/18 (78%)9/18 (50%)
    Cyst208120.3–17.474.724.684.8414/20 (70%)8/20 (40%)7/20 (35%)
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Ultrafast Brain MRI Can Be Used for Indications beyond Shunted Hydrocephalus in Pediatric Patients
A. Tekes, S.S. Senglaub, E.S. Ahn, T.A.G.M. Huisman, E.M. Jackson
American Journal of Neuroradiology Jul 2018, DOI: 10.3174/ajnr.A5724
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Cite this article
A. Tekes, S.S. Senglaub, E.S. Ahn, T.A.G.M. Huisman, E.M. Jackson
Ultrafast Brain MRI Can Be Used for Indications beyond Shunted Hydrocephalus in Pediatric Patients
American Journal of Neuroradiology Jul 2018, DOI: 10.3174/ajnr.A5724

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