Endoscopic Third Ventriculostomy: A Discussion and Pictorial Review

Endoscopic third ventriculostomy is an option in treating select cases of hydrocephalus. Imaging plays a key role in the diagnosis and management of hydrocephalus and in preoperative and postoperative endoscopic third ventriculostomy evaluation. With the use of specific sequences, MR imaging provides optimal characterization of the floor of the third ventricle and CSF flow. This enables accurate assessment of stoma patency and any subtle change in the size of the stoma or the quality of CSF flow through it.

Learning Objective: To discuss the role of ETV in managing hydrocephalus, to describe interpretation criteria for preoperative MR imaging in potential candidates for ETV, to describe interpretation criteria for postoperative MR imaging of ETV, and to discuss the pearls and pitfalls in imaging interpretation.