Dynamic Physiologic Changes in Lumbar CSF Volume Quantitatively Measured By Three-Dimensional Fast Spin-Echo MRI

Lee, Roland R.; Abraham, Robert; Quinn, Cynthia B.

doi:10.1097/00007632-200105150-00016

Cited by 43 publications

(41 citation statements)

References 17 publications

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“…Because the activity peak was stationary, located at the injection site, and there was no sign of any intracranial displacement of the radionuclide, we conclude that CSF was absorbed from the spinal SAS. We could not measure the lumbar CSF volume in our participants, but other groups have reported the lumbar volume in younger healthy individuals to vary between 28 and 81 ml (8,26,30), with a mean of ϳ50 ml. On the basis of these figures, we estimate a mean spinal CSF absorption of ϳ10 ml/h, equivalent to 0.17 ml/min and with a range between 0.09 and 0.27 ml/min.…”

Section: Discussionmentioning

confidence: 91%

Spinal CSF absorption in healthy individuals

Edsbagge

Tisell

Jacobsson

et al. 2004

American Journal of Physiology-Regulatory, Integrative and Comp

143

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The present study examines the extent of spinal cerebrospinal fluid (CSF) absorption in healthy individuals in relation to physical activity, CSF production, intracranial pressure (ICP), and spinal CSF movement. Thirty-four healthy individuals aged 21-35 yr were examined by lumbar puncture and radionuclide cisternography with repeated imaging. ICP was registered before and after CSF drainage, and CSF production was calculated. Spinal CSF absorption was calculated as reduction in spinal radionuclide activity. The radionuclide activity in the spinal subarachnoidal space was gradually decreased by 20 Ϯ 13% (mean Ϯ SD) during 1 h. The reduction was higher in active than in resting individuals (27 Ϯ 12% vs. 13 Ϯ 9%). The mean ICP in 19 of the individuals was 13.6 Ϯ 3.1 cmH 2O. B-waves were found in 79% of the individuals, with a mean frequency of 0.6 Ϯ 0.3 min Ϫ1 . The mean CSF production rate was 0.34 Ϯ 0.13 ml/min. There were no correlations between radionuclide reduction, spinal movement of the radionuclide, and CSF production rate. The spinal radionuclide reduction found in this study indicates a spinal CSF absorption of 0.11-0.23 ml/min, more pronounced in active than in resting individuals. arachnoid villi; cerebrospinal fluid spinal flow; cerebrospinal fluid production; cerebrospinal fluid pressure; radionuclide imaging CEREBROSPINAL FLUID (CSF) is mainly produced in the choroid plexus in the lateral, third, and fourth ventricles, and a minor part is derived from the extracellular space of the brain (37). The CSF flows in a to-and-fro movement with a caudaldirected net flow through the aqueduct of Sylvius and foramina of Luschka and Magendie into the spinal subarachnoidal space (SAS) (39). The pulsative brain movements create a "mixing" of CSF in the fourth ventricle, basal cisterns, and upper spinal SAS (17, 23). Older radionuclide cisternographic (RC) studies have shown that radioactively labeled substances move upward when injected in the lumbar region (11) and downward when injected in the ventricles (12). Within the spinal SAS, a pulsatile to-and-fro flow with a caudal-directed net flow in the ventral and a cranial-directed net flow in the lateral cervical SAS has been reported (25, 42). However, the existence of a CSF bulk flow in any direction within the spinal SAS has been questioned, and RC and MRI observations could be explained by mere diffusion (22). The arachnoid villi in the superior sagittal sinus have generally been thought to be the main site for CSF absorption in humans (2, 40). However, lymphatic drainage pathways have been shown in animal studies to play an important role for CSF clearance (5,27,46). The existence of this pathway in humans remains unclear. Spinal CSF absorption through arachnoid granulations located along the nerve roots, morphologically similar to cranial villi, was suggested by Kido et al. (28), and CSF clearance from the spinal SAS has been demonstrated in sheep and cats (6, 31). The extent and importance of the spinal absorption pathway in humans remain unclear and, to ...

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Section: Discussionmentioning

confidence: 91%

Spinal CSF absorption in healthy individuals

Edsbagge

Tisell

Jacobsson

et al. 2004

American Journal of Physiology-Regulatory, Integrative and Comp

143

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“…During the preliminary study (Reinitz et al, 2013), we validated the measurement process with a Plexiglas model of the canine SA space following the method of Lee et al (2001), resulting in 99.96% accuracy. Additionally, the volume of water in the aforementioned containers was measured with every subject using the same segmentation algorithm, resulting in 99.8 ± 3.1% accuracy.…”

Section: Resultsmentioning

confidence: 99%

Linear relationship found by magnetic resonance imaging between cerebrospinal fluid volume and body weight in dogs

Reinitz

Bajzik

Garamvölgyi

et al. 2017

Acta Veterinaria Hungarica

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Despite numerous studies on cerebrospinal fluid (CSF) and its importance during hydrocephalus or myelography, no reliable values exist about its overall volume in dogs. In this study, our aim was to measure the intracranial (IC) volume of CSF in dogs and assess its possible relationship with body size and the symmetry of the lateral ventricles. We ran a 3D magnetic resonance imaging (MRI) sequence on the central nervous system of 12 healthy, male mongrel dogs between 3-5 years of age and 7.5-35.0 kg body weight. A validated semiautomatic segmentation protocol was implemented to segment the CSF and measure its volume. Values for the volume of the ventricular compartment were between 0.97 and 2.94 ml, with 62.1 ± 11.7% in the lateral ventricles, 17.6 ± 4.9% in the third ventricle, 4.9 ± 1.6% in the aqueductus mesencephali and 15.5 ± 6.6% in the fourth ventricle. In 11 cases a significant asymmetry was found between the lateral ventricles. The results suggest that it may be normal for a dog to have one of the lateral ventricles 1.5 times larger than the other. The correlation between body weight and CSF volume was linear, indicating that the current dosage protocols for myelography, based on a hypothetical proportional relationship with body weight, may have to be revised.

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“…Indeed, if such homeostatic processes were not active we might expect to see larger changes in brain structure following dehydration. As brain volume decreases, the empty space is filled by CSF; this may come from an increase in production or a decrease in absorption of CSF, or from the CSF filled spinal dural sack which unlike the cranium, can change its volume in response to intracranial pressure [Lee et al, 2001;Lofgren and Zwetnow, 1973]. The ROI analysis using MEASURE did not identify any differences in third or lateral ventricular volume following dehydration.…”

Section: Brain Changes Following Dehydrationmentioning

confidence: 86%

Effects of acute dehydration on brain morphology in healthy humans

Kempton

Ettinger

Schmechtig

et al. 2007

Human Brain Mapping

100

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Dehydration can affect brain structure which has important implications for human health. In this study, we measured regional changes in brain structure following acute dehydration. Healthy volunteers received a structural MRI scan before and after an intensive 90-min thermal-exercise dehydration protocol. We used two techniques to determine changes in brain structure: a manual point counting technique using MEASURE, and a fully automated voxelwise analysis using SIENA. After the exercise regime, participants lost (2.2% 6 0.5%) of their body mass. Using SIENA, we detected expansion of the ventricular system with the largest change occurring in the left lateral ventricle (P 5 0.001 corrected for multiple comparisons) but no change in total brain volume (P 5 0.13). Using manual point counting, we could not detect any change in ventricular or brain volume, but there was a significant correlation between loss in body mass and third ventricular volume increase (r 5 0.79, P 5 0.03). These results show ventricular expansion occurs following acute dehydration, and suggest that automated longitudinal voxelwise analysis methods such as SIENA are more sensitive to regional changes in brain volume over time compared with a manual point counting technique. Hum Brain Mapp 30: [291][292][293][294][295][296][297][298] 2009. V V C 2007 Wiley-Liss, Inc.

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Dynamic Physiologic Changes in Lumbar CSF Volume Quantitatively Measured By Three-Dimensional Fast Spin-Echo MRI

Abstract: MRI provides a noninvasive means to measure spinal CSF volume and demonstrates the anatomic basis of physiologic volume changes. This has important implications for spinal anesthesia.

Cited by 43 publications

References 17 publications

Spinal CSF absorption in healthy individuals

Spinal CSF absorption in healthy individuals

Linear relationship found by magnetic resonance imaging between cerebrospinal fluid volume and body weight in dogs

Effects of acute dehydration on brain morphology in healthy humans

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