Ventricular Shunt Radiographs: Still Relevant in the Cross-Sectional Era? Pictorial Review of the Radiographic Appearance of Ventricular Shunts and Approach to Interpreting Shunt Series Radiographs

Lee, M.J.; Streicher, D.A.; Howard, B.M.; Mullins, M.E.; Allen, J.W.

View Article on Neurographics Website

Date of Activity Release: Aug. 1, 2016
Date of Activity Expiration: Aug. 1, 2019

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objectives:
To describe the radiographic appearance of different ventricular shunt types and differentiate them from shunt mimics, to understand common sites and mechanisms of shunt malfunction, to describe an approach to shunt series interpretation, and to understand the advantages and disadvantages of shunt series and other modalities used in the evaluation of suspected shunt malfunction.

In our experience, radiologists are becoming less confident and less comfortable interpreting shunt radiographs, likely a result of a shift in radiology residency training toward cross-sectional imaging. However, shunt series remain a relevant choice for the interrogation of shunt integrity due to the advantages of minimal radiation exposure, ready availability, and rapid examination times. Accurate radiographic diagnosis of shunt malfunction requires the following: 1) an understanding of the ventricular shunt components and their radiographic appearance, 2) a systematic approach to the interpretation of shunt series, and 3) knowledge of the common types and sites of shunt malfunction. The aim of this pictorial review was to outline our approach to shunt series and to provide radiologists with a compendium of illustrative radiographic examples of normal and abnormal ventricular shunts.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

Authors have no relevant financial relationships.





Barton Branstetter 

Editor in Chief

None, N/A

Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

None, N/A

Mark Mullins

Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

Michele Johnson

Associate Editor

Consultant, Boston Scientific, Inc.

Edward Escott

Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

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