Abstract
Introduction
Most myelomeningocele (MMC) cases exhibit ventriculomegaly or hydrocephalus, yet a comprehensive volumetric assessment of MMC intracranial structures is lacking. This study aims to provide baseline data on intracranial structural volume immediately after birth in postnatally repaired MMC infants.
Methods
In this retrospective single-center study, we analyzed 52 MMC infants undergoing postnatal closure, utilizing head computer tomography scans at birth for volumetric assessment. Intracranial volume (ICV), lateral ventricles volume (LVV), choroid plexus volume (CPV), and posterior cranial fossa volume (PCFV) were measured. Comparative analysis with healthy controls (eight infants at 0 months) employed the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis discriminated cases with and without ventriculoperitoneal shunt (VPS).
Results
MMC infants exhibited significant differences compared to healthy cases in LVV (33.18 mL vs. 2.05 mL, p < 0.001), CPV (0.67 mL vs. 0.25 mL, p = 0.005), and PCFV (21.35 mL vs. 39.50 mL, p < 0.001), but not in ICV (407.50 mL vs. 418.15 mL, p = 0.25). Thirty-seven cases (71.15%) underwent VPS. ROC analysis revealed an LVV cut-off value of 6.74 mL for discriminating cases with and without VPS.
Conclusion
Postnatally repaired MMC infants showed significantly larger LVV and CPV, and smaller PCFV compared to healthy infants, providing crucial baseline data for volumetric evaluation. These findings enhance our understanding of intracranial volumetric changes in MMC, facilitating more objective assessments of MMC cases.