The Value of MRI Brain DWI (ADC) in the Management of Ventriculomegaly in Pediatric Age Group

Abstract
Background: Neurosurgeons need to answer the question: Which infant with an enlarged ventricular system needs neurosurgical intervention (progressive pressure hydroceph-alus) and which one needs to be left alone and diagnosis of compensated pressure hydrocephalus is established using MRI brain DWI (ADC) as well as a useful follow-up tool for the treatment success.
Aim of the Work: Investigate the role of ADC's value in children with hydrocephalus to differentiate between compen-sated and progressive hydrocephalus and follow-up after neurosurgical interventions.
Patients and Methods: This prospective study included (40 participants) 10 controls (5 males and 5 females) and 30 patients (18 males and 12 females). All the patients underwent routine MRI brain and DWI (ADC) examinations.
Results: In our study, we found that DWI (ADC) is a useful non invasive tool in diagnosis and follow-up the treatment success in hydrocephalic children, providing us the mean ADC cut off value (1.0817) for differentiation (compen-sated from progressive pressure).
Conclusion: Elevated ADC values in children with pro-gressive hydrocephalus and normalization of the previously high mean ADC value associated with successful neurosurgical intervention, however some patients can present with borderline ADC values and diagnosis of PPH based on the clinical background of the patient and follow-ups. The patients with compensated pressure hydrocephalus, there is no significant decrease of the calculated mean ADC value with follow-ups.