A Morphometric Study of Ventricular System of Human Brain by Computerised Tomography in an Indian Population and its Clinical Significance

Research Article

Austin J Anat. 2017; 4(4): 1075.

A Morphometric Study of Ventricular System of Human Brain by Computerised Tomography in an Indian Population and its Clinical Significance

Honnegowda TM¹*, Nautiyal A² and Deepanjan M²

¹Human Anatomy, Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal, Manipal University, India

²Nuclear Medicine Physicist, Institute of Nuclear Medicine and Molecular Imaging, AMRI Hospitals, India

*Corresponding author: Dr. Honnegowda TM Ph.D, Department of Human Anatomy, Kannur Medical College, Kannur, Kerala, India

Received: September 30, 2017; Accepted: December 15, 2017; Published: December 22, 2017


Background and Aim: The human brain undergoes many gross and histopathological changes with regression of the brain tissue leading to the enlargement of the ventricles as age advances. Knowledge of morphometric and size of normal ventricular system of brain is of paramount importance to understand these changes.

Methods: For the present perspective study, Computerized Tomography (CT) for 250 patients (Males-130 and Females-120) were studied for the measurements of lateral ventricle, third ventricle and fourth ventricle and it was statistically analyzed.

Results: The antero -posterior extent of the body of the lateral ventricles on the right side was 77.45 ± 8.6 and 71.36 ± 9.4 in the males and females and on the left side was 76.6 ± 8.4 and 71.09 ± 9.4mm in the males and females; the length of the frontal horns on the right side was 30.54 ± 3.4 and 28.4 ± 4.2mm in the males and females and on the left side was 30.14 ± 4.7 and 27.4 ± 3.2 mm in the males and females respectively. The width and height of the fourth ventricle were 13.0 ± 1.9 and 10.0 ± 2.1 mm in the males and 12.0 ± 2.0 mm and 9.6 ± 2.2 mm in the females respectively. The width of the third ventricle was 5.9 ± 1.5 and 5.5 ± 1.9 mm in the males and females respectively.

Conclusion: The present study has defined the morphometric measurements of the lateral ventricles, third ventricle, and fourth ventricle of the brain which has clinical correlations in diagnosis and for appropriate treatment.

Keywords: Brain; Morphometry; Ventricular System; Size; Subjects; Tomography


The cavity with in the brain is ventricles filled with Cerebrospinal Fluid (CSF). The lateral ventricles are the largest paired ventricles present within the cerebrum; the third ventricle is in the diencephalon of the forebrain between the thalami; and the fourth ventricle is located posterior to the Pons and open part of the medulla oblongata of the hindbrain [1].

Objective and morphometric studies of human brain ventricles is under limelight, recently due to it is relation with several pathologies evidences such as schizophrenia, hydrocephalus, tumors, Trauma and as well as gender and aging which could lead to dementia [2]. By CT scanning ventricles of the brain can be studied and well visualized, and their overall configuration can be reconstructed from a series of contiguous slices [3]. Knowing the normal measurements of the cerebral ventricles in the living human has great importance in the diagnosis and monitoring of several pathologies [4]. It should be noted that there is a continuous debate in the literature of neuroanatomy, psychiatry, neuroradiology and neurology over the best method of assessing the various parts of the cerebral ventricular system and the information known regarding the accurate measurements of the brain ventricles is limited [5]. Since very few work has been done on measurement of cerebral ventricular system in india the present work is undertaken to study morphometric analysis of the lateral, third and fourth ventricles of the brain in normal Indian subjects using CT scan.

Materials and Methods

Selection and study Population

This prospective study population composed of 250 patients (130 males and 120 females) in the age group of 12 to 81 years, attending the department for Brain PET/CT procedure at Institute of Nuclear Medicine & Molecular Imaging, AMRI Hospital, Kolkata.

These patients were selected randomly and clinically confirmed no history of cerebral infarction, local mass lesions, probable communicating hydrocephalus, alcoholism, drug abuse, trauma or previous intra-cranial surgery and other hereditary diseases and were not on medication at the time of this study. All patients were in fasting condition (minimum 6 hrs) before undergone for the CT procedure. PET /CT scan of all patients were reported by expert nuclear Medicine physician scoring as normal.

Procedure of CT scanning technique

The CT scanner used in this study was the General electric GE discovery 690 PET/CT (64 slices). The selected exposure factors for the CT scan were 80-120 kvp and 250-450 mAs, the slice thickness was 3 mm and the noise index was 3. All CT Scans was performed in axial mode with iterative reconstruction algorithm.

The patient was placed on the PET/CT table and the head was centralized and supported for correct positioning and to avoid blurring of images. A lateral scout image was taken to confirm correct positioning of patient. Orbito-meatal line was drawn and a line at an angle of 15 - 20 degrees to and 1 cm above it was drawn, representing the lowest tomographic section, which passed through the base of skull. Total time of CT scan was 20-30 second followed by PET. A total of 8 to 10 sections were obtained without any overlap [6,7]. All processing and measurement of axial CT images were performed in ADW work station.

Method of measuring the brain ventricle

The measurements were taken as follows:

1) Lateral Ventricle Measurement

a) Length of right lateral ventricular body inclusive of level of interventricular foramen. Frontal horn (taken from tip of frontal horn to the atrium).

b) Length of left lateral ventricular body inclusive of frontal horn (taken from tip of frontal horn to the atrium) can be seen in (Figure 1).