Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?
Identifieur interne : 001C08 ( Istex/Corpus ); précédent : 001C07; suivant : 001C09Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?
Auteurs : F. Hertel ; C. Walter ; M. Schmitt ; M. Mörsdorf ; W. Jammers ; H P Busch ; M. BettagSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2003-04.
English descriptors
- KwdEn :
- CT, computed tomography, HHS, Homburg hydrocephalus scale, IM, index map, MRI, magnetic resonance imaging, MTT, mean transit time, NI, negative integral, NPH, normal pressure hydrocephalus, PwMRI, perfusion weighted magnetic resonance imaging, SPECT, SPECT, 99mTc-bicisate single photon emmision tomography, STT, spinal tap test, TTP, time to peak, clinical outcome, normal pressure hydrocephalus, perfusion weighted MRI.
Abstract
Objective: The aim of this study was to evaluate the combination of spinal tap test (STT) with cerebral perfusion measurement assessed either by Tc-bicisate-SPECT (Tc-SPECT) or perfusion weighted MRI (pwMRI), or both, for a better preoperative selection of promising candidates for shunt operations in suspected idiopathic normal pressure hydrocephalus. Methods: 27 consecutive patients were examined with a standard clinical protocol (assessed by the Homburg Hydrocephalus Scale (HHS)) as well as with 99m Tc-bicisate-SPECT (n=27) or additionally by pwMRI (n=12) before and after STT. The results of these examinations were compared preoperatively for each patient and correlated with postoperative clinical outcome after shunt surgery. Results: Nine patients showed both, a clinical improvement, and increased cerebral perfusion after STT. They underwent shunt surgery with good to excellent results. In another nine patients increasing cerebral perfusion was detected although they did not show a clear clinical improvement after STT. Six of them also received a shunt operation with good to excellent outcome. Three patients of the last group could have an operation. Nine patients did not show any clinical improvement or any kind of increasing cerebral perfusion after STT. Therefore, they did not undergo surgery. The results of SPECT and pwMRI correlated in 92 % of the patients (11 of 12). Conclusion: It is concluded that a combination of clinical assessment with SPECT or pwMRI is helpful in the preoperative selection of patients for shunting procedures with suspected NPH syndrome. This combination is a minimal invasive and objective test modality that is superior to STT alone. Further studies are necessary for a comparison of the described imaging techniques with different diagnostic tests in this difficult field of cerebral disease.
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DOI: 10.1136/jnnp.74.4.479
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ISTEX:7AAE85F29897BB33FAD73028BAFE84F8A34511BCLe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title><author><name sortKey="Hertel, F" sort="Hertel, F" uniqKey="Hertel F" first="F" last="Hertel">F. Hertel</name><affiliation><mods:affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Walter, C" sort="Walter, C" uniqKey="Walter C" first="C" last="Walter">C. Walter</name><affiliation><mods:affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Neuropsychological Research, University of Trier</mods:affiliation></affiliation></author><author><name sortKey="Schmitt, M" sort="Schmitt, M" uniqKey="Schmitt M" first="M" last="Schmitt">M. Schmitt</name><affiliation><mods:affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Morsdorf, M" sort="Morsdorf, M" uniqKey="Morsdorf M" first="M" last="Mörsdorf">M. Mörsdorf</name><affiliation><mods:affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Jammers, W" sort="Jammers, W" uniqKey="Jammers W" first="W" last="Jammers">W. Jammers</name><affiliation><mods:affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Busch, H P" sort="Busch, H P" uniqKey="Busch H" first="H P" last="Busch">H P Busch</name><affiliation><mods:affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Bettag, M" sort="Bettag, M" uniqKey="Bettag M" first="M" last="Bettag">M. Bettag</name><affiliation><mods:affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:7AAE85F29897BB33FAD73028BAFE84F8A34511BC</idno><date when="2003" year="2003">2003</date><idno type="doi">10.1136/jnnp.74.4.479</idno><idno type="url">https://api.istex.fr/document/7AAE85F29897BB33FAD73028BAFE84F8A34511BC/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001C08</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001C08</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title><author><name sortKey="Hertel, F" sort="Hertel, F" uniqKey="Hertel F" first="F" last="Hertel">F. Hertel</name><affiliation><mods:affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Walter, C" sort="Walter, C" uniqKey="Walter C" first="C" last="Walter">C. Walter</name><affiliation><mods:affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Neuropsychological Research, University of Trier</mods:affiliation></affiliation></author><author><name sortKey="Schmitt, M" sort="Schmitt, M" uniqKey="Schmitt M" first="M" last="Schmitt">M. Schmitt</name><affiliation><mods:affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Morsdorf, M" sort="Morsdorf, M" uniqKey="Morsdorf M" first="M" last="Mörsdorf">M. Mörsdorf</name><affiliation><mods:affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Jammers, W" sort="Jammers, W" uniqKey="Jammers W" first="W" last="Jammers">W. Jammers</name><affiliation><mods:affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Busch, H P" sort="Busch, H P" uniqKey="Busch H" first="H P" last="Busch">H P Busch</name><affiliation><mods:affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</mods:affiliation></affiliation></author><author><name sortKey="Bettag, M" sort="Bettag, M" uniqKey="Bettag M" first="M" last="Bettag">M. Bettag</name><affiliation><mods:affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2003-04">2003-04</date><biblScope unit="volume">74</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="479">479</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">7AAE85F29897BB33FAD73028BAFE84F8A34511BC</idno><idno type="DOI">10.1136/jnnp.74.4.479</idno><idno type="href">jnnp-74-479.pdf</idno><idno type="PMID">12640067</idno><idno type="local">0740479</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>CT, computed tomography</term><term>HHS, Homburg hydrocephalus scale</term><term>IM, index map</term><term>MRI, magnetic resonance imaging</term><term>MTT, mean transit time</term><term>NI, negative integral</term><term>NPH, normal pressure hydrocephalus</term><term>PwMRI, perfusion weighted magnetic resonance imaging</term><term>SPECT</term><term>SPECT, 99mTc-bicisate single photon emmision tomography</term><term>STT, spinal tap test</term><term>TTP, time to peak</term><term>clinical outcome</term><term>normal pressure hydrocephalus</term><term>perfusion weighted MRI</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: The aim of this study was to evaluate the combination of spinal tap test (STT) with cerebral perfusion measurement assessed either by Tc-bicisate-SPECT (Tc-SPECT) or perfusion weighted MRI (pwMRI), or both, for a better preoperative selection of promising candidates for shunt operations in suspected idiopathic normal pressure hydrocephalus. Methods: 27 consecutive patients were examined with a standard clinical protocol (assessed by the Homburg Hydrocephalus Scale (HHS)) as well as with 99m Tc-bicisate-SPECT (n=27) or additionally by pwMRI (n=12) before and after STT. The results of these examinations were compared preoperatively for each patient and correlated with postoperative clinical outcome after shunt surgery. Results: Nine patients showed both, a clinical improvement, and increased cerebral perfusion after STT. They underwent shunt surgery with good to excellent results. In another nine patients increasing cerebral perfusion was detected although they did not show a clear clinical improvement after STT. Six of them also received a shunt operation with good to excellent outcome. Three patients of the last group could have an operation. Nine patients did not show any clinical improvement or any kind of increasing cerebral perfusion after STT. Therefore, they did not undergo surgery. The results of SPECT and pwMRI correlated in 92 % of the patients (11 of 12). Conclusion: It is concluded that a combination of clinical assessment with SPECT or pwMRI is helpful in the preoperative selection of patients for shunting procedures with suspected NPH syndrome. This combination is a minimal invasive and objective test modality that is superior to STT alone. Further studies are necessary for a comparison of the described imaging techniques with different diagnostic tests in this difficult field of cerebral disease.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>F Hertel</name><affiliations><json:string>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</json:string></affiliations></json:item><json:item><name>C Walter</name><affiliations><json:string>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</json:string><json:string>Centre for Neuropsychological Research, University of Trier</json:string></affiliations></json:item><json:item><name>M Schmitt</name><affiliations><json:string>Department of Nuclear Medicine, Brüderkrankenhaus Trier</json:string></affiliations></json:item><json:item><name>M Mörsdorf</name><affiliations><json:string>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</json:string></affiliations></json:item><json:item><name>W Jammers</name><affiliations><json:string>Department of Nuclear Medicine, Brüderkrankenhaus Trier</json:string></affiliations></json:item><json:item><name>H P Busch</name><affiliations><json:string>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</json:string></affiliations></json:item><json:item><name>M Bettag</name><affiliations><json:string>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Hydrocephalus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiology (diagnostics)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>normal pressure hydrocephalus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>perfusion weighted MRI</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SPECT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>clinical outcome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>NPH, normal pressure hydrocephalus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MRI, magnetic resonance imaging</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>CT, computed tomography</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STT, spinal tap test</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PwMRI, perfusion weighted magnetic resonance imaging</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HHS, Homburg hydrocephalus scale</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>IM, index map</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MTT, mean transit time</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>NI, negative integral</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SPECT, 99mTc-bicisate single photon emmision tomography</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>TTP, time to peak</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objective: The aim of this study was to evaluate the combination of spinal tap test (STT) with cerebral perfusion measurement assessed either by Tc-bicisate-SPECT (Tc-SPECT) or perfusion weighted MRI (pwMRI), or both, for a better preoperative selection of promising candidates for shunt operations in suspected idiopathic normal pressure hydrocephalus. Methods: 27 consecutive patients were examined with a standard clinical protocol (assessed by the Homburg Hydrocephalus Scale (HHS)) as well as with 99m Tc-bicisate-SPECT (n=27) or additionally by pwMRI (n=12) before and after STT. The results of these examinations were compared preoperatively for each patient and correlated with postoperative clinical outcome after shunt surgery. Results: Nine patients showed both, a clinical improvement, and increased cerebral perfusion after STT. They underwent shunt surgery with good to excellent results. In another nine patients increasing cerebral perfusion was detected although they did not show a clear clinical improvement after STT. Six of them also received a shunt operation with good to excellent outcome. Three patients of the last group could have an operation. Nine patients did not show any clinical improvement or any kind of increasing cerebral perfusion after STT. Therefore, they did not undergo surgery. The results of SPECT and pwMRI correlated in 92 % of the patients (11 of 12). Conclusion: It is concluded that a combination of clinical assessment with SPECT or pwMRI is helpful in the preoperative selection of patients for shunting procedures with suspected NPH syndrome. This combination is a minimal invasive and objective test modality that is superior to STT alone. Further studies are necessary for a comparison of the described imaging techniques with different diagnostic tests in this difficult field of cerebral disease.</abstract><qualityIndicators><score>9.584</score><pdfVersion>1.1</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>18</keywordCount><abstractCharCount>1852</abstractCharCount><pdfWordCount>4584</pdfWordCount><pdfCharCount>29643</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>276</abstractWordCount></qualityIndicators><title>Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title><pmid><json:string>12640067</json:string></pmid><refBibs><json:item><host><volume>273</volume><pages><first>17</first></pages><author></author><title>N Engl J 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Neurosurg</title></host></json:item><json:item><host><volume>34</volume><pages><first>96</first></pages><author></author><title>Neurology</title></host></json:item><json:item><host><volume>18</volume><pages><first>1074</first></pages><author></author><title>Stroke</title></host></json:item><json:item><host><volume>32</volume><pages><first>1358</first></pages><author></author><title>Neurology</title></host></json:item><json:item><host><volume>104</volume><pages><first>689</first></pages><author></author><title>J Neural Transm</title></host></json:item></refBibs><genre><json:string>research-article</json:string></genre><host><volume>74</volume><pages><first>479</first></pages><issn><json:string>0022-3050</json:string></issn><issue>4</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><categories><wos><json:string>social science</json:string><json:string>psychiatry</json:string><json:string>science</json:string><json:string>surgery</json:string><json:string>clinical neurology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>neurology & neurosurgery</json:string></scienceMetrix></categories><publicationDate>2003</publicationDate><copyrightDate>2003</copyrightDate><doi><json:string>10.1136/jnnp.74.4.479</json:string></doi><id>7AAE85F29897BB33FAD73028BAFE84F8A34511BC</id><score>1.8434153</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/7AAE85F29897BB33FAD73028BAFE84F8A34511BC/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/7AAE85F29897BB33FAD73028BAFE84F8A34511BC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/7AAE85F29897BB33FAD73028BAFE84F8A34511BC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>Copyright 2003 Journal of Neurology Neurosurgery and Psychiatry</p></availability><date>2003-04-01</date></publicationStmt><notesStmt><note>Correspondence to:
Dr F Hertel, Neurochirurgie im Brüderkrankenhaus, Nordallee 1, D-54292 Trier, Germany;
F.Hertel@bk-trier.de</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title><author xml:id="author-1"><persName><forename type="first">F</forename><surname>Hertel</surname></persName><affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</affiliation></author><author xml:id="author-2"><persName><forename type="first">C</forename><surname>Walter</surname></persName><affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</affiliation><affiliation>Centre for Neuropsychological Research, University of Trier</affiliation></author><author xml:id="author-3"><persName><forename type="first">M</forename><surname>Schmitt</surname></persName><affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</affiliation></author><author xml:id="author-4"><persName><forename type="first">M</forename><surname>Mörsdorf</surname></persName><affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</affiliation></author><author xml:id="author-5"><persName><forename type="first">W</forename><surname>Jammers</surname></persName><affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</affiliation></author><author xml:id="author-6"><persName><forename type="first">H P</forename><surname>Busch</surname></persName><affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</affiliation></author><author xml:id="author-7"><persName><forename type="first">M</forename><surname>Bettag</surname></persName><affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2003-04"></date><biblScope unit="volume">74</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="479">479</biblScope></imprint></monogr><idno type="istex">7AAE85F29897BB33FAD73028BAFE84F8A34511BC</idno><idno type="DOI">10.1136/jnnp.74.4.479</idno><idno type="href">jnnp-74-479.pdf</idno><idno type="PMID">12640067</idno><idno type="local">0740479</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2003-04-01</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: The aim of this study was to evaluate the combination of spinal tap test (STT) with cerebral perfusion measurement assessed either by Tc-bicisate-SPECT (Tc-SPECT) or perfusion weighted MRI (pwMRI), or both, for a better preoperative selection of promising candidates for shunt operations in suspected idiopathic normal pressure hydrocephalus. Methods: 27 consecutive patients were examined with a standard clinical protocol (assessed by the Homburg Hydrocephalus Scale (HHS)) as well as with 99m Tc-bicisate-SPECT (n=27) or additionally by pwMRI (n=12) before and after STT. The results of these examinations were compared preoperatively for each patient and correlated with postoperative clinical outcome after shunt surgery. Results: Nine patients showed both, a clinical improvement, and increased cerebral perfusion after STT. They underwent shunt surgery with good to excellent results. In another nine patients increasing cerebral perfusion was detected although they did not show a clear clinical improvement after STT. Six of them also received a shunt operation with good to excellent outcome. Three patients of the last group could have an operation. Nine patients did not show any clinical improvement or any kind of increasing cerebral perfusion after STT. Therefore, they did not undergo surgery. The results of SPECT and pwMRI correlated in 92 % of the patients (11 of 12). Conclusion: It is concluded that a combination of clinical assessment with SPECT or pwMRI is helpful in the preoperative selection of patients for shunting procedures with suspected NPH syndrome. This combination is a minimal invasive and objective test modality that is superior to STT alone. Further studies are necessary for a comparison of the described imaging techniques with different diagnostic tests in this difficult field of cerebral disease.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Hydrocephalus</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Radiology</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Radiology (diagnostics)</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>normal pressure hydrocephalus</term></item><item><term>perfusion weighted MRI</term></item><item><term>SPECT</term></item><item><term>clinical outcome</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>NPH, normal pressure hydrocephalus</term></item><item><term>MRI, magnetic resonance imaging</term></item><item><term>CT, computed tomography</term></item><item><term>STT, spinal tap test</term></item><item><term>PwMRI, perfusion weighted magnetic resonance imaging</term></item><item><term>HHS, Homburg hydrocephalus scale</term></item><item><term>IM, index map</term></item><item><term>MTT, mean transit time</term></item><item><term>NI, negative integral</term></item><item><term>SPECT, 99mTc-bicisate single photon emmision tomography</term></item><item><term>TTP, time to peak</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2003-04-01">Created</change><change when="2003-04">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/7AAE85F29897BB33FAD73028BAFE84F8A34511BC/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0740479</article-id><article-id pub-id-type="other">jnnp;74/4/479</article-id><article-id pub-id-type="doi">10.1136/jnnp.74.4.479</article-id><article-id pub-id-type="pmid">12640067</article-id><article-id pub-id-type="other">479</article-id><article-id pub-id-type="other">jnnp.74.4.479</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Paper</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Hydrocephalus</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Radiology</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Radiology (diagnostics)</subject></subj-group></article-categories><title-group><article-title>Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hertel</surname><given-names>F</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Walter</surname><given-names>C</given-names></name><xref rid="AFF2">2</xref><xref rid="AFF4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Schmitt</surname><given-names>M</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Mörsdorf</surname><given-names>M</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Jammers</surname><given-names>W</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Busch</surname><given-names>H P</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bettag</surname><given-names>M</given-names></name><xref rid="AFF1">1</xref></contrib><aff id="AFF1"><label>1</label>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</aff><aff id="AFF2"><label>2</label>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</aff><aff id="AFF3"><label>3</label>Department of Nuclear Medicine, Brüderkrankenhaus Trier</aff><aff id="AFF4"><label>4</label>Centre for Neuropsychological Research, University of Trier</aff></contrib-group><author-notes><corresp>Correspondence to:
Dr F Hertel, Neurochirurgie im Brüderkrankenhaus, Nordallee 1, D-54292 Trier, Germany;
<ext-link xlink:href="F.Hertel@bk-trier.de" ext-link-type="email" xlink:type="simple">F.Hertel@bk-trier.de</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>4</month><year>2003</year></pub-date><pub-date pub-type="epub"><day>1</day><month>4</month><year>2003</year></pub-date><volume>74</volume><volume-id pub-id-type="other">74</volume-id><volume-id pub-id-type="other">74</volume-id><issue>4</issue><issue-id pub-id-type="other">jnnp;74/4</issue-id><issue-id pub-id-type="other">4</issue-id><issue-id pub-id-type="other">74/4</issue-id><fpage>479</fpage><history><date date-type="received"><day>30</day><month>09</month><year>2002</year></date><date date-type="rev-recd"><day>27</day><month>12</month><year>2002</year></date></history><permissions><copyright-statement>Copyright 2003 Journal of Neurology Neurosurgery and Psychiatry</copyright-statement><copyright-year>2003</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-74-479.pdf"></self-uri><abstract xml:lang="en"><p><bold>Objective:</bold> The aim of this study was to evaluate the combination of spinal tap test (STT) with cerebral perfusion measurement assessed either by Tc-bicisate-SPECT (Tc-SPECT) or perfusion weighted MRI (pwMRI), or both, for a better preoperative selection of promising candidates for shunt operations in suspected idiopathic normal pressure hydrocephalus.</p><p><bold>Methods:</bold> 27 consecutive patients were examined with a standard clinical protocol (assessed by the Homburg Hydrocephalus Scale (HHS)) as well as with 99m Tc-bicisate-SPECT (n=27) or additionally by pwMRI (n=12) before and after STT. The results of these examinations were compared preoperatively for each patient and correlated with postoperative clinical outcome after shunt surgery.</p><p><bold>Results:</bold> Nine patients showed both, a clinical improvement, and increased cerebral perfusion after STT. They underwent shunt surgery with good to excellent results. In another nine patients increasing cerebral perfusion was detected although they did not show a clear clinical improvement after STT. Six of them also received a shunt operation with good to excellent outcome. Three patients of the last group could have an operation. Nine patients did not show any clinical improvement or any kind of increasing cerebral perfusion after STT. Therefore, they did not undergo surgery. The results of SPECT and pwMRI correlated in 92 % of the patients (11 of 12).</p><p><bold>Conclusion:</bold> It is concluded that a combination of clinical assessment with SPECT or pwMRI is helpful in the preoperative selection of patients for shunting procedures with suspected NPH syndrome. This combination is a minimal invasive and objective test modality that is superior to STT alone. Further studies are necessary for a comparison of the described imaging techniques with different diagnostic tests in this difficult field of cerebral disease.</p></abstract><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>normal pressure hydrocephalus</kwd><kwd>perfusion weighted MRI</kwd><kwd>SPECT</kwd><kwd>clinical outcome</kwd></kwd-group><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>NPH, normal pressure hydrocephalus</kwd><kwd>MRI, magnetic resonance imaging</kwd><kwd>CT, computed tomography</kwd><kwd>STT, spinal tap test</kwd><kwd>PwMRI, perfusion weighted magnetic resonance imaging</kwd><kwd>HHS, Homburg hydrocephalus scale</kwd><kwd>IM, index map</kwd><kwd>MTT, mean transit time</kwd><kwd>NI, negative integral</kwd><kwd>SPECT, <sup>99m</sup>Tc-bicisate single photon emmision tomography</kwd><kwd>TTP, time to peak</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Is a combination of Tc-SPECT or perfusion weighted magnetic resonance imaging with spinal tap test helpful in the diagnosis of normal pressure hydrocephalus?</title></titleInfo><name type="personal"><namePart type="given">F</namePart><namePart type="family">Hertel</namePart><affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Walter</namePart><affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</affiliation><affiliation>Centre for Neuropsychological Research, University of Trier</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Schmitt</namePart><affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Mörsdorf</namePart><affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">W</namePart><namePart type="family">Jammers</namePart><affiliation>Department of Nuclear Medicine, Brüderkrankenhaus Trier</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H P</namePart><namePart type="family">Busch</namePart><affiliation>Department of Radiology and Neuroradiology, Brüderkrankenhaus Trier</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Bettag</namePart><affiliation>Department of Neurosurgery, Brüderkrankenhaus Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Hydrocephalus</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Radiology</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Radiology (diagnostics)</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2003-04</dateIssued><dateCreated encoding="w3cdtf">2003-04-01</dateCreated><copyrightDate encoding="w3cdtf">2003</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Objective: The aim of this study was to evaluate the combination of spinal tap test (STT) with cerebral perfusion measurement assessed either by Tc-bicisate-SPECT (Tc-SPECT) or perfusion weighted MRI (pwMRI), or both, for a better preoperative selection of promising candidates for shunt operations in suspected idiopathic normal pressure hydrocephalus. Methods: 27 consecutive patients were examined with a standard clinical protocol (assessed by the Homburg Hydrocephalus Scale (HHS)) as well as with 99m Tc-bicisate-SPECT (n=27) or additionally by pwMRI (n=12) before and after STT. The results of these examinations were compared preoperatively for each patient and correlated with postoperative clinical outcome after shunt surgery. Results: Nine patients showed both, a clinical improvement, and increased cerebral perfusion after STT. They underwent shunt surgery with good to excellent results. In another nine patients increasing cerebral perfusion was detected although they did not show a clear clinical improvement after STT. Six of them also received a shunt operation with good to excellent outcome. Three patients of the last group could have an operation. Nine patients did not show any clinical improvement or any kind of increasing cerebral perfusion after STT. Therefore, they did not undergo surgery. The results of SPECT and pwMRI correlated in 92 % of the patients (11 of 12). Conclusion: It is concluded that a combination of clinical assessment with SPECT or pwMRI is helpful in the preoperative selection of patients for shunting procedures with suspected NPH syndrome. This combination is a minimal invasive and objective test modality that is superior to STT alone. Further studies are necessary for a comparison of the described imaging techniques with different diagnostic tests in this difficult field of cerebral disease.</abstract><note type="author-notes">Correspondence to:
Dr F Hertel, Neurochirurgie im Brüderkrankenhaus, Nordallee 1, D-54292 Trier, Germany;
F.Hertel@bk-trier.de</note><subject lang="en"><genre>KWD</genre><topic>normal pressure hydrocephalus</topic><topic>perfusion weighted MRI</topic><topic>SPECT</topic><topic>clinical outcome</topic></subject><subject lang="en"><genre>ABR</genre><topic>NPH, normal pressure hydrocephalus</topic><topic>MRI, magnetic resonance imaging</topic><topic>CT, computed tomography</topic><topic>STT, spinal tap test</topic><topic>PwMRI, perfusion weighted magnetic resonance imaging</topic><topic>HHS, Homburg hydrocephalus scale</topic><topic>IM, index map</topic><topic>MTT, mean transit time</topic><topic>NI, negative integral</topic><topic>SPECT, 99mTc-bicisate single photon emmision tomography</topic><topic>TTP, time to peak</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2003</date><detail type="volume"><caption>vol.</caption><number>74</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>479</start></extent></part></relatedItem><identifier type="istex">7AAE85F29897BB33FAD73028BAFE84F8A34511BC</identifier><identifier type="DOI">10.1136/jnnp.74.4.479</identifier><identifier type="href">jnnp-74-479.pdf</identifier><identifier type="PMID">12640067</identifier><identifier type="local">0740479</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2003 Journal of Neurology Neurosurgery and Psychiatry</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/document/7AAE85F29897BB33FAD73028BAFE84F8A34511BC/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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