Flow dynamics of cerebrospinal fluid: assessment with phase-contrast velocity MR imaging performed with retrospective cardiac gating.

Abstract

To visualize the flow of cerebrospinal fluid (CSF) throughout the ventricles and subarachnoid space, measure mean and maximum CSF velocities, and quantitate CSF flow through the aqueduct of Sylvius, magnetic resonance (MR) imaging was performed with a sagittal technique that is flow-sensitive in the craniocaudal direction (along the readout axis) and a high-resolution axial technique sensitive to through-plane flow in three healthy subjects and 19 patients with known or suspected disorders of the CSF circulation. In both techniques, retrospective cardiac gating was used to cover the complete cardiac cycle. The sagittal technique was superior in overall assessment of CSF flow dynamics, including the motion of adjacent brain parenchyma. The high-resolution axial technique provided an accurate measurement of the rate of CSF flow through the aqueduct; only this technique provided sufficient accuracy to enable distinction between normal and hyperdynamic CSF flow. It is concluded that assessment of CSF flow dynamics is a useful adjunct to routine MR imaging in communicating and obstructive hydrocephalus.

Correlation of diffusion tensor imaging and phase-contrast MR with clinical parameters of cervical spinal cord injuries

“…17 PC-MRI determinations of CSF flow have been used to detect Chiari malformations in the cisterna magna and hydrocephalus, which are regions with a relatively wide SAS in the cerebrospinal junction or cerebral aqueduct. [5][6][7] The pulsatility of the CSF, initially determined myelographically, is associated with choroid plexus pulsations and is modulated by the respiratory cycle. 18,19 Cine phase-contrast flow methods can image and perhaps quantify CSF pulsatile flow.…”

“…18,19 Cine phase-contrast flow methods can image and perhaps quantify CSF pulsatile flow. 5,20 To the best of our Figure 4 Peak systolic and diastolic velocities of CSF in normal controls and SCI patients. Significant differences between increased peak systolic velocities at injury level in SCI patients and significant decreased peak diastolic velocities in SCI patients at below level (*Po0.05).…”

“…Moreover, phase-contrast MRI (PC-MRI) is a noninvasive technique that can be used to quantify variations in the flow of the cerebrospinal fluid (CSF) gated with the cardiac cycle. 5 CSF flow can be influenced by stenotic lesions in the brain and spinal cord. 6,7 Initially, SCI results in the physical disruption of structures in the spinal cord (primary insult), and it might also induce secondary events that injure intact, neighboring tissues in the epidural, subdural, subarachnoid and intramedullary spaces.…”

Intracranial Pressure versus Phase-Contrast MR Imaging for Normal Pressure Hydrocephalus

“…This result led us in the early 1990s to use PCMR to determine the volume of CSF flowing up or down over the cardiac cycle (ie, the ASV). 2 In the mid-1990s, we evaluated 19 patients with symptoms of NPH who were subsequently shunted. 3 All 13 patients with an ASV of Ͼ42 uL on that particular MR imaging system responded to shunting, while only half of the 6 patients with an ASV of Ͻ42 uL responded (ie, the ASV as we measured it had a 100% positive predictive value).…”

Cine cerebrospinal fluid imaging in multiple sclerosis

“…Cine phase contrast MRI has been previously used for CSF flow quantification in healthy controls (HC), patients with hydrocephalus, stroke patients, the elderly, etc (6)(7)(8)(9).…”