The Study of MRI in Brain Development and External Hydrocephalus of Neonates and Infants_West China Medical Journal

Authors：

 ZHANGLei ,  RENZhuan-qin , CHENTao , WANGXiao-hu , HUOMin-hua , WANGXiao-qiang , LIJing , LILi , RENHui-peng , GOUXiao-guang

Department of Radiology, Baoji Central Hospital, Baiji, Shaanxi 721008, P. R. China;

Corresponding author：

RENZhuan-qin, Email: Renzhuanqin@163.com

Keywords：

Infants; Extracerebral space; External hydrocephalus; Magnetic resonance imaging

DOI：

10.7507/1002-0179.20140572

Video：

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Objective To measure the ventricular size and extracerebral space of normal neonates and infants, and discuss the diagnostic criteria of MRI in external hydrocephalus. Methods Neonates and infants suspected to have brain diseases treated in our hospital from January 2009 to January 2013 were selected, and through strict inclusion and exclusion, 671 neonates and infants within 3 years of age and without neural system disease were included in our study. They were divided into 9 age groups. The ventricular size was measured on T1WI, that was bifrontal index, bibody index and the ratio of ventricle and cranial cavity diameter (VT/ST). And the width of extracerebral space, intercerebral fissure and sylvian fissure were measured on T2WI. A total of 149 neonates and infants with external hydrocephalus underwent the same measurement, and the changes in external hydrocephalus were dynamically observed. Results Ventricular volume increased gradually with age, but the bifrontal index[(0.32±0.05) mm] and the ratio of VT/ST (14.09%±1.56%) were relatively constant. The extracerebral space widened with age during 0-6 months, after which it began to narrow, and the age of 3-6 months was the turning point for this trend. The frontal subarachnoid, intercerebral fissure, and sylvian fissure of infants with external hydrocephalus were wider than standard values of the corresponding age group, and the ratio of VT/ST was less than 15%. Conclusion The standard values of ventricular size and extracerebral space of each age group provide the basis for the evaluation of brain development. Among them, the bifrontal index and the ratio of VT/ST are reliable indicators to determine the ventricular size. Subarachnoid depth, intercerebral fissure, and the ratio of VT/ST play an important role in the diagnosis of EH. But for secondary external hydrocephalus, early treatment should be carried out.

Citation： ZHANGLei, RENZhuan-qin, CHENTao, WANGXiao-hu, HUOMin-hua, WANGXiao-qiang, LIJing, LILi, RENHui-peng, GOUXiao-guang. The Study of MRI in Brain Development and External Hydrocephalus of Neonates and Infants. West China Medical Journal, 2014, 29(10): 1895-1899. doi: 10.7507/1002-0179.20140572 Copy

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2.	Dinçer A1, Özek MM. Radiologic evaluation of pediatric hydrocephalus[J]. Childs Nerv Syst, 2011, 27(10):1543-1562.
3.	张素玲, 黄璧璇, 徐桂萍, 等. 婴儿外部性脑积水对运动发育的影响及预后分析[J]. 中国妇幼保健, 2010, 25(20):2835-2836.
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8.	Hadzagić-Catibusić F, Gavranović M, Zubcević S. Ultrasound differentiation between benign enlargement of the subarachnoid space and brain atrophy[J]. Med Arh, 2002, 56(3 Suppl 1):11-13.
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10.	Alkins R, Huang Y, Pajek D, et al. Cavitation-based third ventriculostomy using MRI-guided focused ultrasound[J]. J Neurosurg, 2013, 119(6):1520-1529.
11.	Binz DD. Toussaint LG 3rd, Friedman JA. Hemorrhagic complications of ventriculostomy placement:a meta-analysis[J]. Neurocrit Care, 2009, 10(2):253-256.
12.	Piatt JH. Monozygotic twins discordant for external hydrocephalus[J]. Pediatr Neurosurg, 2001, 35(4):211-215.
13.	何洪浩. 婴幼儿外部性脑积水26例CT分析[J]. 广西医学, 2008, 30(3):422-423.
14.	Rekate HL. A contemporary definition and classification of hydrocephalus[J]. Semin Pediatr Neurol, 2009, 16(1):9-15.
15.	张学川, 赵洪静, 杨启明, 等. 小儿外部性脑积水不同时间、体位变化的CT表现和临床分析[J]. 中国当代医药, 2012, 19(29):90-91, 93.
16.	Lam WW, Ai VH, Wong V, et al. Ultrasonographic measurement of subarachnoid space in normal infants and children[J]. Pediatr Neurol, 2001, 25(5):380-384.
17.	Fenichel GM. 儿科神经系统疾病鉴别诊断和治疗[M]. 3版. 廖建湘,译.北京:人民卫生出版社, 2000:361-362.
18.	Ravid S, Maytal J. Extenal hydrocephalus:a probable cause for subdural hematoma in infancy[J]. Pediatr Neurol, 2003, 28(2):139-141.

1. Aubert-Broche B, Fonov V, Leppert I, et al. Human brain myelination from birth to 4.5 years[J]. Med Image Comput Comput Assist Interv, 2008, 11(Pt 2):180-187.
2. Dinçer A1, Özek MM. Radiologic evaluation of pediatric hydrocephalus[J]. Childs Nerv Syst, 2011, 27(10):1543-1562.
3. 张素玲, 黄璧璇, 徐桂萍, 等. 婴儿外部性脑积水对运动发育的影响及预后分析[J]. 中国妇幼保健, 2010, 25(20):2835-2836.
4. 中田义隆,能势忠男,本贵夫,等.小儿CTの正常像について[J].脑と发达, 1980, 12:478-450.
5. 彭赞新. 婴幼儿外部性脑积水的CT诊断与鉴别诊断[J]. 中国医疗前沿, 2009, 4(16):76, 102.
6. Mcardle CB, Richardson CJ, Nicholas DA, et al. Developmental features of the neonatal brain:Mr imaging. PartⅡ:ventricular size and extracerebral space[J]. Radiology, 1987, 162(1):230-234.
7. 周志强, 傅全意, 叶崇云, 等. 特发性外部性脑积水的CT诊断及跟踪观察[J]. 中国CT和MRI杂志, 2004, 2(3):15-16, 19.
8. Hadzagić-Catibusić F, Gavranović M, Zubcević S. Ultrasound differentiation between benign enlargement of the subarachnoid space and brain atrophy[J]. Med Arh, 2002, 56(3 Suppl 1):11-13.
9. Dandy WE. Experimental hydrocephalus[J]. Ann Surg, 1919, 70(2):129-142.
10. Alkins R, Huang Y, Pajek D, et al. Cavitation-based third ventriculostomy using MRI-guided focused ultrasound[J]. J Neurosurg, 2013, 119(6):1520-1529.
11. Binz DD. Toussaint LG 3rd, Friedman JA. Hemorrhagic complications of ventriculostomy placement:a meta-analysis[J]. Neurocrit Care, 2009, 10(2):253-256.
12. Piatt JH. Monozygotic twins discordant for external hydrocephalus[J]. Pediatr Neurosurg, 2001, 35(4):211-215.
13. 何洪浩. 婴幼儿外部性脑积水26例CT分析[J]. 广西医学, 2008, 30(3):422-423.
14. Rekate HL. A contemporary definition and classification of hydrocephalus[J]. Semin Pediatr Neurol, 2009, 16(1):9-15.
15. 张学川, 赵洪静, 杨启明, 等. 小儿外部性脑积水不同时间、体位变化的CT表现和临床分析[J]. 中国当代医药, 2012, 19(29):90-91, 93.
16. Lam WW, Ai VH, Wong V, et al. Ultrasonographic measurement of subarachnoid space in normal infants and children[J]. Pediatr Neurol, 2001, 25(5):380-384.
17. Fenichel GM. 儿科神经系统疾病鉴别诊断和治疗[M]. 3版. 廖建湘,译.北京:人民卫生出版社, 2000:361-362.
18. Ravid S, Maytal J. Extenal hydrocephalus:a probable cause for subdural hematoma in infancy[J]. Pediatr Neurol, 2003, 28(2):139-141.

West China Medical Journal

The Study of MRI in Brain Development and External Hydrocephalus of Neonates and Infants

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