Using the present sequence, we obtained images that accentuated CSF motion, which is largely composed of irregular motion. This method does not require pulse triggering or complex post-processing of images and allows visualization of CSF motion in a short period of time in selected whole imaging planes. It can therefore be applied clinically to diagnose various diseases that cause abnormalities in the CSF space.

The motion of cerebrospinal fluid (CSF) within the subarachnoid space and ventricles is greatly modulated when propagating synchronously with the cardiac pulse and respiratory cycle and path through the nerves, blood vessels, and arachnoid trabeculae. Water molecule movement that propagates between two spaces via a stoma, foramen, or duct presents increased acceleration when passing through a narrow area and can exhibit "turbulence." Recently, neurosurgeons have started to perform fenestration procedures using neuroendoscopy to treat hydrocephalus and cystic lesions. As part of the postoperative evaluation, a noninvasive diagnostic technique to visualize the water molecules at the fenestrated site is necessary. Because turbulence is observed at this fenestrated site, an imaging technique appropriate for observing this turbulence is essential. We therefore investigated the usefulness of a dynamic improved motion-sensitized driven-equilibrium steady-state free precession (Dynamic iMSDE SSFP) sequence of magnetic resonance imaging that is superior for ascertaining turbulent motions in healthy volunteers and patients. Images of Dynamic iMSDE SSFP from volunteers revealed that CSF motion at the ventral surface of the brainstem and the third ventricle is augmented and turbulent. Moreover, our findings confirmed that this technique is useful for evaluating treatments that utilize neuroendoscopy. As a result, Dynamic iMSDE SSFP, a simple sequence for visualizing CSF motion, entails a short imaging time, can extensively visualize CSF motion, does not require additional processes such as labeling or trigger setting, and is anticipated to have wide-ranging clinical applications in the future.

To investigate spatial distribution properties of the cardiac- and respiratory-driven cerebrospinal fluid (CSF) motions in the intracranial space, correlation mapping technique was conducted. Time series of CSF velocity were acquired in 7 healthy subjects of 26±5 years old under by asynchronous 2-dimensional phase contrast (2D-PC) method with 217-msec temporal resolution. The delay time and maximum correlation maps of the cardiac- and respiratory-driven CSF motions demonstrated clear differences in the propagation properties. When the reference region was set at anterior spinal subarachnoid space, the maximum correlation coefficients in the case of 6-sec respiratory period were 0.91±0.05 for cardiac-driven and 0.78±0.08 for respiratory-driven. They were 0.90±0.06 and 0.81±0.06 in the case of 10-sec period. The cardiac- and respiratory CSF motions differently distributed in intracranial space.

To classify the cardiac- and respiratory-driven cerebrospinal fluid (CSF) motions, asynchronous 2D phase contrast (PC) of magnetic resonance imaging (MRI) with 217 ms time resolution in conjunction with power and frequency mapping was performed for 7 healthy subjects under respiration guidance. In the frequency domain, the cardiac-driven motion was at around 1.29±0.21 Hz and respiratory-driven motion was at 0.16±0.01 Hz under 6 sec respiratory cycle. Two different techniques were proposed for characterizing the motions; one was power-map (P-map) depicting integrated power spectrum in a selected band, and the other was frequency-map (F-map) delineating the frequency of maximum peak in power spectral density (PSD). These maps visualized the anatomical distributions of the two motions. Portions of the cardiac- and respiratory-driven CSF motions in the spinal subarachnoid space were 58.1±22.2 and 9.50±3.83 %, respectively. Power and frequency mapping clearly classified the cardiac-driven and respiratory-driven CSF motions.

The feasibility of the 3D dynamic improved motion-sensitized driven-equilibrium steady-state free precession (3D dynamic iMSDE SSFP) was evaluated for visualizing CSF motion and the appropriate parameters were determined. Both flow phantom and volunteer studies revealed that linear ordering and the shortest acquisition duration time were optimal. 3D dynamic iMSDE SSFP provides good quality imaging of CSF motion in the whole brain and enables visualization of flow in arbitrary planes from a single 3D volume scan.