PEDIATRICS Vol. 72 No. 5 November 1983, pp. 670-676
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Lumbar Cisternography in Evaluation of Hydrocephalus in the Preterm Infant

Steven M. Donn MD1, Dietrich W. Roloff MD1, and John W. Keyes Jr MD1

1 From the Departments of Pediatrics, Section of Newborn Services, and Internal Medicine, Division of Nuclear Medicine, University of Michigan Medical School, Ann Arbor

Radionuclide lumbar cisternography using indium 111-diethylenetriamine pentaacetic acid (111 In-DTPA) and a mobile ggr-camera with a converging collimator was utilized as a bedside procedure to evaluate CSF dynamics and the patency of the cerebral ventricular system in 30 preterm infants with hydrocephalus. Serial images of the brain were obtained at 0, 1, 2, 6, 24, and 48 hours after instillation of the isotope in the lumbar subarachnoid space. Three distinct patterns were seen. Infants with posthemorrhagic hydrocephalus displayed prompt ventricular filling but markedly delayed emptying with minimal flow over the cerebral convexities. Infants with ventriculomegaly secondary to suspected brain atrophy or periventricular leukomalacia demonstrated a pattern of prompt ventricular filling, delayed emptying, but with flow present over the convexities. An infant with noncommunicating hydrocephalus secondary to an Arnold-Chiari malformation showed a pattern of complete obstruction with no ventricular filling. Radionuclide lumbar cisternography appears to be a safe, well-tolerated procedure which produces images of sufficient resolution to provide valuable information about CSF dynamics, delineating basal cisternae, ventricles, and subarachnoid flow paths.

Key Words: cisternography • hydrocephalus • preterm infant

Submitted on December 17, 1982
Accepted on January 28, 1983