The intracranial pressure (ICP) is an important factor in the proper functioning of the brain. This pressure is needed to be constantly regulated, since an abnormal elevation can be quite dangerous. In this article, we develop some numerical tools to better understand the regulation of this pressure. In particular, as it is impossible to measure the ICP in a non-invasive way, these numerical tools can allow to estimate values of the ICP. In addition, we propose to compute the dynamics of the cerebrospinal fluid (CSF), taking into account the connected environment of the skull and the arterio-venous flows. A computational fluid dynamics model in two dimensions is developed for the cerebrospinal fluid system, with Windkessel type boundary conditions. This model shows that the dynamics can impact the distribution of the CSF in the different compartments of the cerebrospinal system.
Kitware SAS, France / USA Abstract. Angiographic imaging is a crucial domain of medical imaging. In particular, Magnetic Resonance Angiography (MRA) is used for both clinical and research purposes. This article presents the first framework geared toward the design of virtual MRA images from real MRA images. It relies on a pipeline that involves image processing, vascular modeling, computational fluid dynamics and MR image simulation, with several purposes. It aims to provide to the whole scientific community (1) software tools for MRA analysis and blood flow simulation; and (2) data (computational meshes, virtual MRAs with associated ground truth), in an open-source / open-data paradigm. Beyond these purposes, it constitutes a versatile tool for progressing in the understanding of vascular networks, especially in the brain, and the associated imaging technologies.
INTRODUCTION
Early diagnosis of NPH during its initial stages is almost impossible, given the delayed onset of clinical symptoms, making the study and the understanding of the CSF dynamics very challenging in human subjects. In this study, we explore these dynamics in a novel animal model with induced chronic communicating hydrocephalus with the aim to better understand the pathophysiology of NPH to pursue earlier diagnostic tools that will ultimately translate into better treatment outcomes.
METHODS
Chronic communicating hydrocephalus was induced in 15 adult Sprague-Dawley rats using a technique developed by our group. Kaolin is injected into the subarachnoid space over the cerebral convexities. Additionally, 4 animals were used as controls and 3 as shams with saline injections. PCMRI was performed to calculate the aqueductal stroke volume (ASV) and T2-W images for ventricular size measurements on days 15, 60, 90, and 120 using a Bruker 11.7-TMR. Nonparametric tests were implemented to analyze the ASV and its correlation with the ventricular volumes after the hydrocephalus induction.
RESULTS
Kaolin-injected (KI) animals showed a significant ventricular enlargement at all time points. A significant difference in ASV was present between KI and controls at all times. There was a significant positive correlation between the ventricular volume expansion and the ASV between 15 and 60 d.
CONCLUSION
An initial active phase of rapid ventricular enlargement shows a strong correlation between the expansion of the ventricular volume and the increment in ASV during the first 60 d, followed by a second phase with a less ventricular enlargement and heterogeneous behavior in the ASV. Results may suggest an optimal window for CSF diversion treatment. This hypothesis will be explored in the following experiment by shunting groups of animals at all time points. Future studies will include an evaluation of the intracranial pressure and histological/microstructural analysis to better understand the ASV variations after 60 d.
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