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Table 8 The use of high-convexity tightness alone for prediction of shunt response in iNPH

From: Radiological predictors of shunt response in the diagnosis and treatment of idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis

Study

Sample size

Radiological methodology

Cutoff specification

Image specification

Image plane

Main reported outcomes

Narita et al. [41]

n = 103

•Observed in 4 uppermost contiguous transverse sections and 3 contiguous coronal sections anterior to and on the posterior commissure. Graded on ordinal scale from 0–3

•N/A

•3D T1-weighted MRI obtained with a Signa 1.5 T MR imaging unit

•Transverse and Coronal

•Simple linear regression analysis: presurgical high-convexity tightness was associated with change in iNPHGS total score (regression coefficient [B] = 1.23, coefficient of determination [R2] = 0.13, p = .004), change in iNPHGS gait score (B = 0.59, R2 = 0.16, p = .002), and change in MMSE (B = 2.56, R2 = 0.17, p = 0.001)

•Multiple linear regression analysis: high convexity tightness predicted change in the iNPHGS total score (B = 0.99, R2 = 0.24, p = .017) and the gait score (B = 0.52, R2 = 0.21, p = .006)

Virhammar et al. [60]

n = 108

•Graded 0–2

•0 = Normal or wider than normal

•1 = slight compression

•2 = definitive compression

•N/A

•T2 Flair, T1-weighted MRI. (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

•Coronal and transverse plane

OR between SR and SNR [1.43 (0.84–2.46), p = 0.2]

  1. Studies included assessing the use of any advanced imaging radiological marker as predictor of shunt responsiveness. SR, shunt response; S-NR, shunt non-response; FLAIR, fluid-attenuated inversion recovery; iNPHGS, idiopathic normal-pressure hydrocephalus grading scale; MMSE, mini mental state examination