UPmémoires

English

Backgroung: The assessment of the size of the cerebral ventricles by the current imaging methods are extrapolations from index calculated with bi-dimensional measurements. However these indexes showed significant individuals and inter observers variabilities, limiting their application in clinical practice, with the exception of monitoring. We assume that the evolution of 3D imaging and reconstruction softwares will enable accurate measurements of ventricular volumes, with the aim of creating a chart of standards ventricular measurements in healthy subjects, by gender and age.

Methods: A single-centre observational study, retrospective, and unblended was performed in patients who underwent brain imaging at Poitiers University Hospital between 2010 and 2016 Participants were randomly selected on our PACS database. Patients who underwent a three-dimensional brain imaging (CT or MRI), normal or enrolling in the "physiological aging" and reported without history potentially confusing were included. Patients who did not have 3D sequences were not included. Patients with factors that may increase the ventricular volume (OH, dementia, genetic defects, ...) were excluded. The measurements were performed on the VITREA reconstruction software, using manual contouring, for ventricular limits until the foramens of Luschka, and for the skull until the foramen magnum.

Ventricular volumes (VV) and skull percentage occupied by the ventricles (PSO) were the two main criteria of judgment. Results: 301 patients were finally included: 149 men and 152 women, aged 3 to 91 years. Average and an upper limit such that the probability of having a VV or PSO below the limit is 95%; were established by gender, decade after decade. We found that globally, there was a slowly progressive linear evolution during the first 6 decades, then a breaking at the age of 60 with accelerated growth of the ventricles. Men had higher VV than women (p <0.05) but PSO differences were not significant (p> 0.05). Finally, we observed that hypertension plays a significant role in accelerating the ventricular growth in the population under 60 years (p <0.05).

Conclusion: A chart of VV and PSO with upper limit (P = 95%) was established in healthy subjects, according to age and gender. It now needs to being confronted to pathological situations to assess its clinical relevance.