Adjustable shunt valve–induced magnetic resonance imaging artifact: a comparative study

Clinical article

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Object

In this paper, the authors' goal was to compare the artifact induced by implanted (in vivo) adjustable shunt valves in spin echo, diffusion weighted (DW), and gradient echo MR imaging pulse sequences.

Methods

The MR images obtained in 8 patients with proGAV and 6 patients with Strata II adjustable shunt valves were assessed for artifact areas in different planes as well as the total volume for different pulse sequences.

Results

Artifacts induced by the Strata II valve were significantly larger than those induced by proGAV valve in spin echo MR imaging pulse sequence (29,761 vs 2450 mm3 on T2-weighted fast spin echo, p = 0.003) and DW images (100,138 vs 38,955 mm3, p = 0.025). Artifacts were more marked on DW MR images than on spin echo pulse sequencse for both valve types.

Conclusions

Adjustable valve–induced artifacts can conceal brain pathology on MR images. This should influence the choice of valve implantation site and the type of valve used. The effect of artifacts on DW images should be highlighted pending the development of less MR imaging artifact–inducing adjustable shunt valves.

Abbreviations used in this paper: DW = diffusion weighted; FSE = fast spin echo.

Article Information

Address correspondence to: Ahmed K. Toma, F.R.C.S.(Neuro. Surg.), Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom. email: ahmedktoma@yahoo.com.

Please include this information when citing this paper: published online October 9, 2009; DOI: 10.3171/2009.9.JNS09171.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Axial T2-weighted (A), coronal T1-weighted (B), and sagittal T1-weighted (C) FSE images, and a DW (D) MR image obtained in a patient with a proGAV valve.

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    Axial T2-weighted (A), coronal T1-weighted (B), and sagittal T1-weighted (C) FSE images, and a DW (D) MR image obtained in a patient with a Strata II valve.

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    Diffusion weighted MR images obtained in a patient with a Strata II valve.

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    The artifact area (in mm2) in different FSE MR imaging planes. The asterisk indicates a statistically significant difference.

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    The artifact area (in mm2) in T2-weighted FSE and DW MR imaging sequences. The asterisk indicates a statistically significant difference.

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    The artifact volume (in mm3) in different T1-weighted and T2-weighted FSE MR imaging sequences. The asterisk indicates a statistically significant difference.

  • View in gallery

    The artifact volume (in mm3) in T2-weighted FSE and DW MR imaging sequences. The asterisk indicates a statistically significant difference.

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