Aims and objectives
Placement of Ventriculoperitoneal (VP)-shunt is a standard procedure for the treatment of hydrocephalus for various conditions like normal pressure hydrocephalus (NPH),
aneurysmal subarachnoid hemorrhage,
Despite being widely used,
the rate of shunt failure after 1 year has been reported to be between 20% to 40% of VP-shunts requiring revision within 6 years of placement (1,2).
These VP-shunts require often revision surgeries that can...
Methods and materials
This retrospective study included 100 patients (mean age: 56.1 ± 18.8 years,
51 female) with suspected VP-Shunt complication who underwent whole Body LD-CT (tube voltage,
100 kVp; tube current-time product,
The CT images were independently reviewed by three radiologists for presence/absence of mechanical VP-shunt complications,
overall image quality and diagnostic confidence.
On a five-point Likert scale the readers scored the IQ (1= very low,
5 very high) and the DC (1= low...
Image quality was rated very good (median score,
Diagnostic confidence was rated very high (median score,
Interobserver agreement was almost perfect for IQ (κ = 0.810) and for DC (κ = 0.808).
Twenty-two out of the 100 included patients had confirmed mechanical VP-Shunt complications.
Twenty-one positive patients were correctly identified on LD-CT by all 3 readers,
no false positive cases were recorded by any of the readers,
yielding a sensitivity of 95.5 %,
Whole-body LD-CT allows detection of VP-Shunt complication with excellent diagnostic accuracy and very high diagnostic confidence. Our results indicate that LD-CT is an accurate diagnostic tool for the detection of VP-shunt complications and have the potential to replace the gold standard (plain radiographic shunt series) in clinical routine.
Chumas PD et al.
(2014) Ventriculoperitoneal shunt 30-day failure rate: a retrospective international cohort study.
(2009) Perioperative risk factors for short term shunt revisions in adult hydrocephalus patients.
J Neurol Neurosurg Psychiatry. 3.
(2015) Evaluation of whole body ultralow-dose CT for the assessment of ventriculoperitoneal shunt complications: an...