Table 5 The use of absence of dilated cortical sulci for prediction of shunt response in iNPH
Study | Sample size | Radiological methodology | Cutoff specification | Image specification | Image plane | Main reported outcomes |
|---|---|---|---|---|---|---|
Black [5] | n = 62 | •N/A | •Absence of sulcal enlargement | •Used both pneumoencephalogram (PEG) and CT | •N/A | •PEG: There was no significant difference between SR and SNR. Sensitivity 66.7%, specificity: 35.7%, PPV:40% and NPV: 62.5%. TP 6, TN5, FP9, FN 3 •CT: Significant difference between SR and SNR, with those with no sulcal enlargement more likely to respond to shunt. Sensitivity 78.6%, specificity: 75.0%, PPV 84.6% and NPV 66.7%. TP: 11, TN:6, FP2, FN3 |
Poca et at. [46] | n = 43 | •Scan categorized into normal, obliterated or enlarged cortical sulci | •N/A | •CT | •N/A | •Sulci were normal in 11, obliterated in 5 and enlarged in 27. There was a significant difference between groups in the information subset of WMS (chi-square = 10.05, p = 0.007). Those with enlarged sulci were less likely to improve in neurocognitive tests after shunting |
Agerskov et al. [2] | n = 168 | •Obliteration of high convexity sulci: No sulci on 10 most cranial slices covering vertex •Transport sulci: Focally enlarged sulci in absence of atrophy. Numbered as 0,1,2, > 2 | •N/A | •MRI 1.5 T. T1-weighted images | •Trans-axial and coronal | Obliterated sulci: •There was no significant difference SR (36% had obliterated sulci) vs. SNR (35%) •There was also no significant correlation with the composite score. (0.19, 0.18, 0.13 for total, gait, and cognition respectively.) Transport sulci: •72% had 0, 17% 1 and 8% had 2 and 3% had > 2. There was no difference between SR and SNR in any of these categories •There was also no significant correlation with the composite score. (0.07, 0.18, 0.08 for total, gait, and cognition respectively.) |
Narita et al. [41] | n = 103 | •Presence (1) or absence (0) noted of focal cortical sulci were evaluated | •N/A | •3D T1-weighted MRI obtained with a Signa 1.5 T MR imaging unit | •Transverse plane | •No significant association with post-surgical improvement reported. (Regression coefficient for total score, gait, cognitive, urinary subsections, TUG and MMSE was 0.71, 0.19, 0.00, 0.53, − 2.25, 1.19 respectively p > 0.1) |
Virhammar et al. [60] | n = 108 | •Accumulation of CSF in focally enlarged sulci was graded as present or absent | •N/A | •9% of patients on 3 T scanner; 70% on a 1.5 T scanner, 14% on a 1 T scanner and 7% on a 0.5 T scanner | •N/A | •OR between SR and SNR [0.54 (0.63–3.73), p = 0.34] was statistically insignificant |