Article
The role of CT perfusion studies in the evaluation of patients with NPH: A pilot study
Die Bedeutung der CT-Perfusion bei der Evaluierung von Patienten mit NPH: Eine Pilotstudie
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Published: | April 11, 2007 |
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Published with erratum: | January 8, 2008 |
Outline
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Objective: Several studies have evaluated cerebral perfusion and hemodynamic parameters (flow velocity/TCD, CBF/PET, rCBF/SPECT, 3D-perfusion/MRI) in regard to their role as predictors of successful shunt surgery in patients with normal pressure hydrocephalus. In a prospective pilot-study we evaluated CT perfusion as an additional method for the evaluation of cerebral perfusion before and after shunt surgery in patients with NPH.
Methods: We examined 12 consecutive patients with typical features of NPH. The patients underwent CT perfusion study prior to shunt surgery and on day 7 following shunt surgery. The pre- and postop studies were evaluated by two independent neuroradiologists in regard to perfusion parameters (regional perfusion deficits, time to peak, mismatching). All patients benefited from the shunting procedure at the one-year follow-up.
Results: In the evaluation of the CT-perfusion studies, no difference was found between pre- and post shunt images. All studies (preoperative as well as postoperative) were read as normal within limits. Minor ischemic deficits seen on CT perfusion have been known and documented in previous examinations. Neither change nor improvement could be seen comparing pre- and postoperative scans.
Conclusions: We conclude that CT perfusion studies do not present a valid method for the evaluation of cerebral perfusion in patients undergoing shunt surgery for NPH. The method has no role in predicting possible successful candidates and also no role in comparing pre- and postoperative brain perfusion.