Non-invasive visualisation of shunt obstruction with constructive interference in steady state (CISS) MRI sequences

Abstract

The diagnosis of ventricular shunt lumen obstruction remains a challenging area. Common methods of assessment are often invasive, while routine imaging techniques are unhelpful in diagnosing shunt obstruction in cases where ventricular size remains unaffected. Constructive Interference in Steady State (CISS) is a 3D gradient echo MRI sequence that accentuates T2 values between cerebrospinal fluid (CSF) and surrounding structures. This clinical image demonstrates the use of CISS MRI, for the first time, to non-invasively demonstrate proximal shunt lumen obstruction in three patients presenting with suspected shunt catheter obstruction.