60-Second MRI Test Helps More Easily Diagnose Shunt Failure in Children with Hydrocephalus

Hydrocephalus, a condition characterized by the buildup of cerebrospinal fluid (CSF) in the brain, is commonly treated by surgically placing a shunt to drain excess fluid to another body part. While shunts are vital for managing hydrocephalus, they can sometimes malfunction, posing serious risks. The primary indicator of a shunt's effectiveness is the flow of fluid through it; a decline in flow suggests the onset of shunt failure. However, accurately diagnosing shunt failure remains a challenge, as there is no definitive test for it. Current methods, such as MRI to check for enlarged brain ventricles, shunt taps, and nuclear medicine studies, are often invasive, painful, or involve radiation exposure, and still, they do not precisely measure the fluid flow through the shunt.

Now, researchers at Children’s Hospital Los Angeles (Los Angeles, CA, USA;) have developed a 60-second MRI test that could significantly enhance the diagnosis of shunt failure in children with hydrocephalus. This test, already being implemented in clinical settings at CHLA, has the potential to improve patient care and foster research advancements. The team, comprising neurosurgeons, radiologists, biomedical engineers, and MRI physicists, utilized phase-contrast MRI, a well-established technology, to tailor an MRI sequence specifically for this purpose, which was then thoroughly tested and validated. Although shunt taps are still the clinical standard, this new MRI test could potentially replace nuclear medicine tests in some scenarios.

Image: The new MRI test could transform shunt failure diagnosis in hydrocephalusy (Photo courtesy of 123RF)

This innovative test can complement standard care for children undergoing evaluation for potential shunt failure. It only adds an extra minute to the usual MRI procedure. By providing more accurate diagnoses of shunt failure, the test not only offers families greater reassurance but also helps prevent unnecessary nuclear medicine tests or surgeries. It could enable earlier diagnosis of shunt issues, averting emergencies for children and their families. Additionally, the test opens new research avenues into shunt flow physiology, such as determining optimal flow values for children and designing shunts to maximize efficiency. The team is planning a national, multicenter clinical trial and conducting studies to understand how various factors, like diet and exercise, influence CSF production.

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Children’s Hospital Los Angeles