Our objective was to clarify intracranial cerebrospinal fluid (CSF) flow dynamics in normalpressure hydrocephalus (NPH). Frequency analyses of CSF flow measured with phase-contrast cine MRI were performed. The CSF flow spectra in the aqueduct were determined in patients (n=51) with NPH, brain atrophy or asymptomatic ventricular dilation (VD), and in healthy volunteers (control group; n=25). The changes in CSF flow spectra were also analyzed after intravenous injection of acetazolamide. Moreover, a phase transfer function (PTF) calculated from the spectra of the driving vascular pulsation and CSF flow in the aqueduct were assessed. These values were compared with the pressure volume response (PVR). The amplitude in the NPH group was significantly larger than that in the VD or control group because of a decrease in compliance. The phase in the NPH group was significantly different from that in either the VD or the control group, but no differ-ence was found between the VD and control groups. The amplitude increased in all groups after acetazolamide injection. The PTF in the NPH group was significantly larger than in the control group, and a positive correlation was noted between PTF and PVR. Frequency analyses of CSF flow measured by cine MRI make it possible to noninvasively obtain a more detailed picture of the pathophysiology of NPH.

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A method was developed for accurate measurement of the modulation transfer function (MTF) and signal-to-noise ratio in the spatial frequency domain (SNR(f)) of magnetic resonance images (MRI). The MTF was calculated from the complex images of a line object which were obtained by the subtraction of two separately acquired data sets of a specially designed phantom with a sliding sheet. Moreover, the SNR(f) was calculated from the MTF and Wiener spectrum, both of which were determined using the same phantom configuration. The MTFs and SNR(f)s in the conventional spin-echo (SE) and turbo SE, in which the effective echo time was set to the first echo, were evaluated by changing the T2 of the phantom and the echo train length. The MTFs in the positive and negative frequencies indicated the effect of the k-space trajectory for each pulse sequence. SNR(f)s gave spatial frequency information that was not obtained with conventional methods. In this method, the influence of image nonuniformity and unwanted artefacts (edge and ghost) could be eliminated. An analysis of the MTF and the SNR in the spatial frequency domain provides additional information for the assessment of image quality in MRI.