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首页> 外文期刊>Neurosurgical focus >Role of radiological parameters in predicting overall shunt outcome after ventriculoperitoneal shunt insertion in pediatric patients with obstructive hydrocephalus
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Role of radiological parameters in predicting overall shunt outcome after ventriculoperitoneal shunt insertion in pediatric patients with obstructive hydrocephalus

机译：放射学参数在小儿梗阻性脑积水患者心室腹膜分流术插入后总分流结局的预测中的作用

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OBJECTIVE Despite significant advances in the medical field and shunt technology, shunt malfunction remains a nightmare of pediatric neurosurgeons. In this setting, the ability to preoperatively predict the probability of shunt malfunction is quite compelling. The authors have compared the preoperative radiological findings in obstructive hydrocephalus and the subsequent clinical course of the patient to determine any association with overall shunt outcome. METHODS This retrospective study included all pediatric patients (age RESULTS A total of 121 patients were eligible for the analysis. Nearly half of the patients (47.9%) required shunt revision. The presence of PVL was associated with lower revision rates than those in others (39.4% vs 58.2%, p = 0.03). None of the preoperative radiological indices or ratios showed any correlation with shunt revision. Nearly half of the patients with shunt revision required early revision ( CONCLUSIONS Preoperative radiological linear indices and ratios do not predict the likelihood of subsequent shunt malfunction. However, patients who required early shunt revision tended to have greater reductions in ventricular volumes on postoperative images. Therefore a greater reduction in ventricular volume is not actually desirable, and a ventricular volume high enough to reduce intracranial pressure is instead to be aimed at for long-term shunt compliance.
机译：目的尽管在医学领域和分流技术上取得了重大进步，但分流故障仍然是小儿神经外科医师的噩梦。在这种情况下，术前预测分流器故障可能性的能力非常引人注目。作者比较了梗阻性脑积水的术前放射学表现和患者随后的临床病程，以确定与总分流结局的关系。方法这项回顾性研究纳入了所有儿科患者（年龄结果，共有121例患者符合分析条件。将近一半（47.9％）的患者需要分流翻修。PVL的存在与较低的翻修率相关（ （39.4％vs 58.2％，p = 0.03）。术前放射学指标或比率均未显示与分流翻修相关。然而，需要早期分流术的患者在术后影像上的心室容积往往会有更大的减少，因此实际上不希望有更大的心室容积减少，而是要有足够高的脑室容积来降低颅内压旨在长期符合分流规范。

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