MR-IMAGING OF VENTRICULOMEGALY - A QUALITATIVE AND QUANTITATIVE COMPARISON OF COMMUNICATING HYDROCEPHALUS, CENTRAL ATROPHY, AND NORMAL STUDIES

Both communicating hydrocephalus and central atrophy cause ventricular dilatation, However, patients with hydrocephalus may require treatmen t. The aim of this study was to assess qualitatively and quantitativel y the efficacy of MR imaging in the differentiation of communicating h ydrocephalus from central atrophy. The midsagittal T1-weighted MR imag es of 33 patients with communicating hydrocephalus, 31 patients with c entral atrophy, and 23 normal subjects were evaluated qualitatively an d quantitatively. This included configuration of the aqueduct; area of the septum pellucidum, third ventricle, and fourth ventricle; and mor phology of the corpus callosum. Distal dilatation of the aqueduct was detected in 33.3% of patients with communicating hydrocephalus and in none of those with central atrophy. The corpus callosum was elevated i n patients with communicating hydrocephalus when compared with that in patients with central atrophy. In conclusion, an analysis of midsagit tal T1-weighted images has identified useful qualitative and quantitat ive criteria in the differentiation of communicating hydrocephalus fro m central atrophy. The configuration of the aqueduct with funneling at the fourth ventricular end strongly suggests the presence of communic ating hydrocephalus rather than central atrophy alone.