Evaluation of Cella Media Index by Computed Tomography in Hydrocephalic Children in Tertiary Hospital of TelanganaA Retrospective Study

Abstract

Introduction: Hydrocephalus is a common clinical condition in children with a mortality rate of 0-3%. Any obstruction in the flow of Cerebrospinal Fluid (CSF) in the ventricular system leads to its collection and accumulation in the brain causing its compression. Such ventricular enlargement can be studied by many linear and volumetric measurements out of which the Cella Media Index (CMI) is one. Computed Tomography (CT) scan is the safest non invasive investigation commonly used by radiologists to study the ventricular system. Aim: To evaluate CMI in hydrocephalic children by CT and also to compare with the control group, attending tertiary hospital in Telangana state. Materials and Methods: A retrospective study was conducted by obtaining CT Scans of 50 normal children and 50 hydrocephalic children within the age group of 0-12 years, from the Department of Radiology, Niloufer Hospital, Hyderabad, Telangana from November 2013 to August 2014. The CT scans were studied and analysed between August 2014 to November 2014. Maximum transverse inner diameter of the skull and maximum width of the cella media were measured and cella media index was calculated. The data was statistically analysed by using T test. One way Analysis of Variance (ANOVA) was used to check for differences in ventricular dimensions across age groups. Results: The mean age of the subjects was 2.9±3.0 years with 51 female and 49 male children. Mean of cella media index in cases (3.02±1.24, 95%CI 2.66-3.37) was less than in controls (11.9±2.87, 95%CI 11.1-12.7) with p-value<0.001. The mean cella media index of males (2.74±0.93, 95%CI 2.66-3.14) was less than in females (3.28±1.40, 95 %CI 2.88-3.37) with p-value=0.1. Among the hydrocephalic children there was no significant difference of mean of cella media index between males and females. The mean cella media index in children below three years (2.81±1.36, 95%CI 2.66-3.12) was less than in children above three years (3.43±0.87, 95%CI 3.09-3.37) with p-value=0.049. Among the hydrocephalic children there was significant difference of mean of cella media index between two age groups. Conclusion: The present study concluded that cella media index in hydrocephalic children was decreased in comparison with the control group.