Setting pressure can change the size and shape of MRI artifacts caused by adjustable shunt valves: a study of the 4 newest models

• Published in: Journal of neurosurgery Vol. 130; no. 4; pp. 1260 - 1267
• Main Authors: Uchida, Daiki, Amano, Yuki, Nakatogawa, Hirokazu, Masui, Takayuki, Ando, Naoto, Nakayama, Teiji, Sato, Haruhiko, Sameshima, Tetsuro, Tanaka, Tokutaro
• Format: Journal Article
• Language: English
• Published: United States 01-04-2019
• Subjects: artifact; magnetic resonance imaging; adjustable valve; hydrocephalus; cerebrospinal fluid shunt
• ISSN: 0022-3085; 1933-0693; 1933-0693
• DOI: 10.3171/2017.12.jns171533

Adjustable shunt valves that have been developed for the management of hydrocephalus all rely on intrinsically magnetic components, and artifacts with these valves on MRI are thus inevitable. The authors have previously reported that the shapes of shunt artifacts differ under different valve pressures with the proGAV 2.0 valve. In the present study the authors compared the size and shape of artifacts at different pressure settings with 4 new-model shunt valves.
The authors attached 4 new models of MRI-resistant shunt valve to the temporal scalp of a healthy volunteer: the proGAV 2.0; Codman Certas Plus; Polaris; and Strata MR. They set 3 different scales of pressures for each valve, depending on magnet orientation to the body axis. Artifacts were evaluated and compared among all valves on a 3.0-T GE scanner and 2 valves were also evaluated on a Philips scanner and a Siemens scanner. In-plane artifact sizes were evaluated as the maximum distance of the artifact from the expected scalp.
The sizes and shapes of artifacts changed depending on valve pressure for all valves on the 3 different MRI scanners. Artifacts were less prominent on spin echo sequences than on gradient echo sequences. For diffusion-weighted imaging and time-of-flight MR angiography, the authors matched image numbers within the same sequence and compared appearances of artifacts. For all valves, the number of images affected by artifacts and the image number showing the largest artifact differed among valve settings.
Artifacts of all adjustable shunt valves showed gross changes corresponding to pressure setting. Not only the maximum distance of artifacts but also the shape changed significantly. The authors suggest that changing pressure settings offers one of the easiest ways to minimize artifacts on MRI.