Objective: To investigate the value of virtual endoscopy in diagnosis and treatment of hydrocephalus after failed shunt.
Methods: we performed magnetic resonance imaging (MRI) 3D-SPACE sequence scanning for 76 patients suffering from hydrocephalus after failed shunt. Based on the DICOM data of 3D-SPACE sequence, we three-dimensionally reconstructed the ventricles and simulated virtual endoscopy with 3D-Slicer software. Surgical strategy was made after evaluation of virtual endoscopy images.
Results: Virtual endoscopy based on 3D-SPACE images was helpful to depict the aqueduct or foramen of Monro obstructions, and confirm the reason of shunt failure. Finally, there were 56 hydrocephalus patients (73.7%) were treated with endoscopic assisted third ventricle fistula (ETV), without shunt catheter insertion.
Conclusion: For patients suffering from shunt failure of hydrocephalus, virtual endoscopy has high diagnostic yield rate for providing more detailed anatomical information than conventional MR imaging. Hence, this advanced imaging method is helpful for surgical treatment strategy decision making.