Examining The Relationship Between Lateral Ventricle Volumetric Index and Linear Indexes in Childhood and Adolescence: A Retrospective MRI Study

Öz

Objective: Indexes obtained from two-dimensional and three-dimensional measurements are used to evaluate the brain's lateral ventricle (LV) structure. However, there were limited studies on how well the Evans index (EI) and the Bicaudate index (BI), which estimate LV volume, represent the LV volumetric index (LVVI) in the childhood and adolescence period. This study investigated the relationship between LVVI and linear indexes (EI and BI) in the pediatric period regarding age and sex factors. Method: This study was performed retrospectively in 588 individuals (267 [45.4%] females) aged 1-18 years with normal brain magnetic resonance images (MRI) between 2012 and 2021. LVVI was obtained by segmenting three-dimensional T1-weighted MRIs with volBrain1.0. LVVI was obtained by dividing the LV absolute volume by the total intracranial volume. We made linear measurements for EI and BI with the 3D Slicer. In this study, we compared the data obtained from individuals in 16 different age ranges between 1-18 years old with SPSS (ver.28). Results: In our study, we found the mean value of LVVI to be 0.656±0.372%. The mean values of EI and BI were 0.242±0.025 and 0.070±0.022, respectively. In the pediatric population, we found that mean values of EI and BI were significantly higher in males than in females (p<0.05). In the pediatric period, LVVI had a positive correlation with EI at a moderate level (r:0.443) and with BI at a high level (r:0.624) (p<0.001). Conclusion: In this study, we presented LVVI data to evaluate LV in the pediatric period. This study showed that using BI instead of EI is more effective in estimating LV volume when LVVI information is unavailable in the pediatric period.

Anahtar Kelimeler

• Lateral ventricles
• Index
• Three-Dimensional Imaging
• Child
• Adolescent

Etik Beyan

The local ethics committee approved the conduct of this study (Bursa Uludag University Faculty of Medicine Clinical Research Ethics Committee, Approval Date: 19.09.2023 Decision Number: 2023-17/20).

Teşekkür

We want to thank Prof. Güven Özkaya (Bursa Uludağ University Faculty of Medicine, Department of Biostatistics) for his consultancy for the statistical analysis of our study.

Kaynakça

1. Scelsi CL, Rahim TA, Morris JA, Kramer GJ, Gilbert BC, Forseen SE. The lateral ventricles: A detailed review of anatomy, development, and anatomic variations. Am J Neuroradiol. 2020;41:566-572.
2. Barra V, Frenoux E, Boire JY. Automatic volumetric measurement of lateral ventricles on magnetic resonance images with correction of partial volume effects. J Magn Reson Imaging. 2002;15:16-22.
3. Synek V, Reuben JR, Du Boulay GH. Comparing Evans’ index and computerized axial tomography in assessing relationship of ventricular size to brain size. Neurology. 1976;26:231-231.
4. Barr AN, Heinze WJ, Dobben GD, Valvassori GE, Sugar O. Bicaudate index in computerized tomography of huntington disease and cerebral atrophy. Neurology. 1978;28:1196–1200.
5. Toma AK, Holl E, Kitchen ND, Watkins LD. Evans’ index revisited: The need for an alternative in normal pressure hydrocephalus. Neurosurgery. 2011;68:939–944.
6. Neikter J, Agerskov S, Hellström P, et al. Ventricular Volume Is More Strongly Associated with Clinical Improvement Than the Evans Index after Shunting in Idiopathic Normal Pressure Hydrocephalus. Am J Neuroradiol. 2020;41:1187–1192.
7. Reinard K, Basheer A, Phillips S, et al. Simple and reproducible linear measurements to determine ventricular enlargement in adults. Surg Neurol Int. 2015;6:59.
8. Ambarki K, Israelsson H, Wåhlin A, Birgander R, Eklund A, Malm J. Brain ventricular size in healthy elderly: Comparison between evans index and volume measurement. Neurosurgery. 2010;67:94–99.

9. Ragan DK, Cerqua J, Nash T, et al. The accuracy of linear indices of ventricular volume in pediatric hydrocephalus: Technical note. J Neurosurg Pediatr. 2015;15:547–551.
10. Bourne SK, Conrad A, Neimat JS, Davis TL. Linear measurements of the cerebral ventricles are correlated with adult ventricular volume. J Clin Neurosci. 2013;20:763–764.
11. Kumar A, Kumari S, Saraswathy R, Rajeshwari M. Evaluation of Evan’s Index in South Indian Population using Computed Tomography. International Journal of Anatomy, Radiology and Surgery. 2017;6(3):RO28-RO31.
12. Bayer SB, Algowiez R, Shetty AC. Development of reference values of evans index using computerized tomographic scan in healthy individuals and comparison with hydrocephalous patients of Saudi origin. Int J Curr Res Rev. 2021;13:S-129-S-132.
13. Dhok A, Gupta P, Shaikh ST. Evaluation of the Evan’s and Bicaudate Index for Rural Population in Central India using Computed Tomography. Asian J Neurosurg. 2020;15:94.
14. Kumbar PB, Sakalecha AK, Chaithanya A, Rajeswari G, Revanth RB, Jayendra Mannan. Evaluation of the Evan’s and Bicaudate index for South Karnataka Population using computed tomography. Asian J Med Sci. 2023;14:201–205.
15. Patnaik P, Singh V, Singh D, Singh S. Age and Gender Related Variations in Lateral Ventricle Brain Ratios. Int J Heal Sci Res. 2016;6(5):78-85.
16. Sari E, Sari S, Akgün V, et al. Measures of Ventricles and Evans’ Index: From Neonate to Adolescent. Pediatr Neurosurg. 2015;50:12–17.
17. Wilk R, Kluczewska E, Syc B, Bajor G. Normative values for selected linear indices of the intracranial fluid spaces based on CT images of the head in children. Polish J Radiol. 2011;76:16.
18. Işıklar S, Sağlam D. Volumetric analysis of age- and sex-related changes in the corpus striatum and thalamus in the 1-18 age group: a retrospective magnetic resonance imaging study. Cereb Cortex. 2024;34.
19. Evans WA. An encephalographic ratio for estimating ventricular enlargement and cerebral atrophy. Arch Neurol Psychiatry. 1942;47:931–937.
20. Manjón J V., Coupé P. Volbrain: An online MRI brain volumetry system. Front Neuroinform. 2016;10:30.
21. Yushkevich PA, Piven J, Hazlett HC, et al. User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliability. Neuroimage. 2006;31:1116–1128.
22. Meese W, Kluge W, Grumme T, Hopfenmüller W. CT evaluation of the CSF spaces of healthy persons. Neuroradiology. 1980;19:131–136.
23. Giedd JN, Snell JW, Lange N, et al. Quantitative magnetic resonance imaging of human brain development: Ages 4-18. Cereb Cortex. 1996;6:551–560.
24. Karacan K, Kosar MI, Çimen M, Solak O, Sahin B. Determination of Lateral Ventricle and Brain Volume in Children with Stereological Method Using MRI. Int J Morphol. 2013;31:211–216.
25. Barron SA, Jacobs L, Kinkel WR. Changes in size of normal lateral ventricles during aging determined by computerized tomography. Neurology. 1976;26:1011–1011.
26. Lange N, Giedd JN, Castellanos FX, Vaituzis AC, Rapoport JL. Variability of human brain structure size: ages 4–20 years. Psychiatry Res Neuroimaging. 1997;74:1–12.
27. Pelicci LJ, Bedrick AD, Cruse RP, van Nucci RC. Frontal Ventricular Dimensions of the Brain in Infants and Children. Arch Neurol. 1979;36:852–853.
28. Doraiswamy PM, Patterson L, Na C, et al. Bicaudate Index on Magnetic Resonance Imaging: Effects of Normal Aging. 1994;7:13–17.
29. Vrij-Van Den Bos S, Hol JA, La Piana R, et al. 4H Leukodystrophy: A Brain Magnetic Resonance Imaging Scoring System. Neuropediatrics. 2017;48:152–160.
30. Garbade SF, Boy N, Heringer J, Kölker S, Harting I. Age-Related Changes and Reference Values of Bicaudate Ratio and Sagittal Brainstem Diameters on MRI. Neuropediatrics. 2018;49:269–275.
31. Von Bezing H, Andronikou S, Van Toorn R, Douglas T. Are linear measurements and computerized volumetric ratios determined from axial MRI useful for diagnosing hydrocephalus in children with tuberculous meningitis? Child’s Nerv Syst. 2012;28:79–85.