Table 18 The use CTC for prediction of shunt response in iNPH
Study | Sample size | Radiological methodology | Cutoff level | Contrast used | Time of CT | Main reported outcomes |
|---|---|---|---|---|---|---|
Kazui et al. [27] | n = 100 | •CTC score: 0–3 depending on stasis and density of contrast in ventricle compared to surrounding brain parenchyma 0 = density in the CSF space is same as in baseline CT scan •Score = 1, density is between 0 and 2 •Score = 2, density is same as the brain parenchyma in baseline CT scan •Score = 3, density is higher than brain parenchyma in baseline CT scan •Lateral ventricles, Sylvian fissure, and parietal sulci | •Low score (0–1) | •iohexol (Omnipaque®: 180 mg/ml) | •0, 6, 24 and 48 h after injection | •Parietal sulci after 48 h- OR: 0.47 (95% CI: 0.25–0.88) p = 0.02 for disappearance of urinary symptoms •CTC score Mean 1.4, SD:1.0 |
Kawaguchi et al. [26] | n = 100 | •CTC score. Stasis of the contrast medium at the lateral ventricles (positive ventricular stasis) and at the Sylvian fissure or the parietal sulci (positive surface stasis) | •High score (indicated more stasis) | •iohexol (Omnipaque®: 180 mg/ml) | •0, 6, 24 and 48 h after injection | •CTC success rate: 85.4% •Ventricular stasis: sensitivity: 0.867, Specificity: 0.20, PPV:0.867, NPV: 0.2 •Surface stasis: sensitivity 0.817, specificity: 0.00, PPV:0.831, NPV 0 •Overall CTC (positive surface AND ventricular stasis): sensitivity 0.95, specificity 0, PPV: 0.851, NPV: 0. TP57, TN0, FP10, FN33 |
Black [5] | n = 62 | •Images were graded as having delayed isotope clearance and failure of convexity ascent, mixed pattern or normal | •N/A | •Not available | •72 h | •11 (33%) of patients had ventricular entry, absence of convexity flow and delayed clearance, of these 73% improved. Normal pattern was seen in 9 with a 55% improvement. Mixed pattern was seen 13 with a 31% improvement rate. No differences were significant •TP: 9, TN: 13, FP:3, FN:9. Sensitivity: 47.1%, specificity: 81.3%, PPV: 72.7%, NPV:59.1% |