{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:00:59Z","timestamp":1784916059485,"version":"3.55.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Hydrocephalus is a common complication of myelomeningocele (MMC), typically managed with a ventriculoperitoneal shunt (VPS). Despite clinical relevance, there remains a paucity of studies quantitatively comparing intracranial and ventricular volumes in shunted versus non-shunted MMC patients. This study aims to determine whether significant volumetric differences exist between these groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ninety-one MRIs from 19 MMC patients (13 shunted, 6 non-shunted), aged 0\u20133\u00a0years, were retrospectively analyzed. Volumes were obtained from rapid-sequence MRIs using automatic segmentation with manual correction. Outcomes included ventricular volume, intracranial volume, and ventricle-to-intracranial volume (ventricle\/ICV) ratio. Analyses included nonparametric tests, mixed-effects models, bootstrap resampling, permutation testing, and robust regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, shunted patients exhibited larger intracranial volumes (644.3 vs 403.5\u00a0mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020) but not ventricular volumes (82.2 vs 34.2\u00a0mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.072) compared to non-shunted patients. Although the ventricle-to-intracranial volume ratio was significantly higher in shunted patients under 50\u00a0days of age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), this difference was no longer significant after adjusting for head circumference and prematurity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.144). Sensitivity analyses confirmed differences in the neonatal period (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), but not in infancy or toddlerhood. Effect-size analyses demonstrated a large difference within 50\u00a0days (Hedges\u2019\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20091.268) that diminished thereafter (\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.452).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Shunted MMC patients demonstrated larger intracranial volumes and higher ventricle\/ICV ratios in the neonatal period, but these differences diminished after 50\u00a0days. Early ventricular enlargement in this cohort\u2019s shunted patients appears robust yet transient, with no sustained volumetric differences between shunted and non-shunted patients later in development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07410-w","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:14:01Z","timestamp":1784913241000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using rapid-sequence MRI scans to compare ventricular and intracranial volumes in shunted and non-shunted children with myelomeningocele: a retrospective observational cohort study"],"prefix":"10.1007","volume":"42","author":[{"given":"Maya","family":"Parker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumou Kalsoum","family":"Mbacke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divine","family":"Nwafor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Kellogg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Hendrix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Spader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"7410_CR1","doi-asserted-by":"publisher","unstructured":"Saarinen O, Piironen S, Pokka T et al (2024) To shunt or not to shunt when closing myelomeningocele? A systematic review and meta-analysis of simultaneous versus delayed ventriculoperitoneal shunt placement in neonates undergoing myelomeningocele closure. https:\/\/doi.org\/10.3171\/2024.5.PEDS23600","DOI":"10.3171\/2024.5.PEDS23600"},{"issue":"9","key":"7410_CR2","doi-asserted-by":"publisher","first-page":"2851","DOI":"10.1007\/s00381-024-06444-2","volume":"40","author":"H Hashimoto","year":"2024","unstructured":"Hashimoto H, Irizato N, Takemoto O, Chiba Y (2024) Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants. Childs Nerv Syst 40(9):2851\u20132858. https:\/\/doi.org\/10.1007\/s00381-024-06444-2","journal-title":"Childs Nerv Syst"},{"issue":"Suppl 2","key":"7410_CR3","doi-asserted-by":"publisher","first-page":"S367","DOI":"10.4103\/0028-3886.332247","volume":"69","author":"JP Blount","year":"2021","unstructured":"Blount JP, Maleknia P, Hopson BD, Rocque BG, Oakes WJ (2021) Hydrocephalus in spina bifida. Neurol India 69(Suppl 2):S367. https:\/\/doi.org\/10.4103\/0028-3886.332247","journal-title":"Neurol India"},{"issue":"8","key":"7410_CR4","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1542\/pir.2023-006318","volume":"45","author":"VM Lu","year":"2024","unstructured":"Lu VM, Shimony N, Jallo GI, Niazi TN (2024) Infant hydrocephalus. Pediatr Rev 45(8):450\u2013460. https:\/\/doi.org\/10.1542\/pir.2023-006318","journal-title":"Pediatr Rev"},{"key":"7410_CR5","doi-asserted-by":"publisher","unstructured":"Dewan MC, Lim J, Gannon SR et al (2018) Comparison of hydrocephalus metrics between infants successfully treated with endoscopic third ventriculostomy with choroid plexus cauterization and those treated with a ventriculoperitoneal shunt: a multicenter matched-cohort analysis. https:\/\/doi.org\/10.3171\/2017.10.PEDS17421","DOI":"10.3171\/2017.10.PEDS17421"},{"issue":"5","key":"7410_CR6","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/s00381-016-3032-3","volume":"32","author":"WA Azab","year":"2016","unstructured":"Azab WA, Mijalcic RM, Nakhi SB, Mohammad MH (2016) Ventricular volume and neurocognitive outcome after endoscopic third ventriculostomy: is shunting a better option? A review. Childs Nerv Syst 32(5):775\u2013780. https:\/\/doi.org\/10.1007\/s00381-016-3032-3","journal-title":"Childs Nerv Syst"},{"issue":"Supplement_1","key":"7410_CR7","doi-asserted-by":"publisher","first-page":"S414","DOI":"10.1093\/ofid\/ofab466.821","volume":"8","author":"V Saini","year":"2021","unstructured":"Saini V, Jaber T, Como JD, Lejeune K, Bhanot N (2021) Exploring \u2018Slicer Dicer\u2019, an extraction tool in EPIC, for clinical and epidemiological analysis. Open Forum Infectious Diseases 8(Supplement_1):S414\u2013S415","journal-title":"Open Forum Infectious Diseases"},{"key":"7410_CR8","unstructured":"(n.d.) CERTASTM Plus programmable valves. https:\/\/products.integralife.com\/file\/general\/1549983654.pdf. Accessed 4 Mar 2026"},{"key":"7410_CR9","unstructured":"POLARIS\u00ae VALVE: Instructions for Use. https:\/\/www.sophysa.us\/wp-content\/uploads\/2023\/11\/Polaris%C2%AE-Instructions-for-Use.pdf. Accessed 4 Mar 2026"},{"key":"7410_CR10","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-018-2951-6","volume":"19","author":"R Scholz","year":"2018","unstructured":"Scholz R, Lemcke J, Meier U, Stengel D (2018) Efficacy and safety of programmable compared with fixed anti-siphon devices for treating idiopathic normal-pressure hydrocephalus (iNPH) in adults \u2013 SYGRAVA: study protocol for a randomized trial. Trials 19:566. https:\/\/doi.org\/10.1186\/s13063-018-2951-6","journal-title":"Trials"},{"issue":"7","key":"7410_CR11","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1097\/SCS.0000000000003929","volume":"28","author":"W Breakey","year":"2017","unstructured":"Breakey W, Knoops PGM, Borghi A et al (2017) Intracranial volume measurement: a systematic review and comparison of different techniques. J Craniofac Surg 28(7):1746. https:\/\/doi.org\/10.1097\/SCS.0000000000003929","journal-title":"J Craniofac Surg"},{"key":"7410_CR12","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.neuroimage.2014.09.034","volume":"104","author":"IB Malone","year":"2015","unstructured":"Malone IB, Leung KK, Clegg S et al (2015) Accurate automatic estimation of total intracranial volume: a nuisance variable with less nuisance. Neuroimage 104:366\u2013372. https:\/\/doi.org\/10.1016\/j.neuroimage.2014.09.034","journal-title":"Neuroimage"},{"issue":"10","key":"7410_CR13","doi-asserted-by":"publisher","first-page":"1951","DOI":"10.3174\/ajnr.A3067","volume":"33","author":"K Ambarki","year":"2012","unstructured":"Ambarki K, Lindqvist T, W\u00e5hlin A et al (2012) Evaluation of automatic measurement of the intracranial volume based on quantitative MR imaging. AJNR Am J Neuroradiol 33(10):1951\u20131956. https:\/\/doi.org\/10.3174\/ajnr.A3067","journal-title":"AJNR Am J Neuroradiol"},{"key":"7410_CR14","doi-asserted-by":"publisher","unstructured":"Warf B, Ondoma S, Kulkarni A et al (2009) Neurocognitive outcome and ventricular volume in children with myelomeningocele treated for hydrocephalus in Uganda. https:\/\/doi.org\/10.3171\/2009.7.PEDS09136","DOI":"10.3171\/2009.7.PEDS09136"},{"key":"7410_CR15","doi-asserted-by":"publisher","unstructured":"Warf BC, Weber DS, Day EL et al (2023) Endoscopic third ventriculostomy with choroid plexus cauterization: predictors of long-term success and comparison with shunt placement for primary treatment of infant hydrocephalus. https:\/\/doi.org\/10.3171\/2023.4.PEDS2310","DOI":"10.3171\/2023.4.PEDS2310"},{"key":"7410_CR16","doi-asserted-by":"publisher","unstructured":"Nikas DC, Post AF, Choudhri AF, Mazzola CA, Mitchell L, Flannery AM (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 10: change in ventricle size as a measurement of effective treatment of hydrocephalus. https:\/\/doi.org\/10.3171\/2014.7.PEDS14330","DOI":"10.3171\/2014.7.PEDS14330"},{"key":"7410_CR17","doi-asserted-by":"publisher","unstructured":"McCarthy DJ, Sheinberg DL, Luther E, McCrea HJ (2019) Myelomeningocele-associated hydrocephalus: nationwide analysis and systematic review. https:\/\/doi.org\/10.3171\/2019.7.FOCUS19469","DOI":"10.3171\/2019.7.FOCUS19469"},{"issue":"1","key":"7410_CR18","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1007\/s00381-020-04786-1","volume":"37","author":"\u0130 \u0130\u015ftemen","year":"2021","unstructured":"\u0130\u015ftemen \u0130, Arslan A, Olguner SK, A\u00e7ik V, \u00d6kten A\u0130, Babao\u011flan M (2021) Shunt timing in meningomyelocele and clinical results: analysis of 80 cases. Childs Nerv Syst 37(1):107\u2013113. https:\/\/doi.org\/10.1007\/s00381-020-04786-1","journal-title":"Childs Nerv Syst"},{"key":"7410_CR19","doi-asserted-by":"publisher","unstructured":"Ozgural O, Kahilogullari G, Dogan I et al (2019) Timing of shunt insertion in children with neural tube defects and hydrocephalus: clinical study. Turkish Neurosurg. https:\/\/doi.org\/10.5137\/1019-5149.JTN.26588-19.1","DOI":"10.5137\/1019-5149.JTN.26588-19.1"},{"issue":"1","key":"7410_CR20","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s00701-019-04143-5","volume":"162","author":"F Grimm","year":"2020","unstructured":"Grimm F, Edl F, Gugel I, Kerscher SR, Bender B, Schuhmann MU (2020) Automatic volumetry of cerebrospinal fluid and brain volume in severe paediatric hydrocephalus, implementation and clinical course after intervention. Acta Neurochir 162(1):23\u201330. https:\/\/doi.org\/10.1007\/s00701-019-04143-5","journal-title":"Acta Neurochir"},{"key":"7410_CR21","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-06825-w","volume":"15","author":"F Wilhelmy","year":"2025","unstructured":"Wilhelmy F, G\u00fcresir E, Wach J et al (2025) Volumetric predictors for shunt-dependency in pediatric posterior fossa tumors. Sci Rep 15:20235. https:\/\/doi.org\/10.1038\/s41598-025-06825-w","journal-title":"Sci Rep"},{"key":"7410_CR22","doi-asserted-by":"publisher","unstructured":"Williams VJ, Juranek J, Stuebing KK et al (2015) Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus. https:\/\/doi.org\/10.3171\/2014.10.PEDS13644","DOI":"10.3171\/2014.10.PEDS13644"},{"key":"7410_CR23","doi-asserted-by":"publisher","unstructured":"Tan K, Meiri A, Mowrey WB et al (2018) Diffusion tensor imaging and ventricle volume quantification in patients with chronic shunt-treated hydrocephalus: a matched case-control study. https:\/\/doi.org\/10.3171\/2017.6.JNS162784","DOI":"10.3171\/2017.6.JNS162784"},{"key":"7410_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresbull.2023.110847","volume":"206","author":"RM Ragguett","year":"2024","unstructured":"Ragguett RM, Eagleson R, de Ribaupierre S (2024) Association between altered white matter networks and post operative ventricle volume in shunt-treated pediatric hydrocephalus. Brain Res Bull 206:110847. https:\/\/doi.org\/10.1016\/j.brainresbull.2023.110847","journal-title":"Brain Res Bull"},{"key":"7410_CR25","doi-asserted-by":"publisher","unstructured":"Kulkarni AV, Donnelly R, Mabbott DJ, Widjaja E (2015) Relationship between ventricular size, white matter injury, and neurocognition in children with stable, treated hydrocephalus. https:\/\/doi.org\/10.3171\/2015.1.PEDS14597","DOI":"10.3171\/2015.1.PEDS14597"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07410-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-026-07410-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07410-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:14:03Z","timestamp":1784913243000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-026-07410-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7410"],"URL":"https:\/\/doi.org\/10.1007\/s00381-026-07410-w","relation":{},"ISSN":["1433-0350"],"issn-type":[{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"30 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of the University of Virginia approved this study.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Xue Feng is a co-founder of Carina Medical who developed the software that was used in this analysis.","order":2,"name":"Ethics","label":"Conflict of interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"308"}}