MRI of Hydrocephalus and CSF Velocity Imaging

Bradley, William G.

doi:10.1002/9780470034590.emrstm0106

Cited by 2 publications

(7 citation statements)

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“…Another CSF flow parameter measured in the Sylvian aqueduct was the stroke volume: the volume of CSF flowing through the aqueduct forward and backward during a cardiac cycle. Brain compliance was regarded as diminished when the stroke volume, representing the compliance and elasticity of the brain, was ≥ 42 μl [ 6 ].…”

Section: Clinical Materials and Methodologymentioning

confidence: 99%

“…It does not require a contrast administration because this technique assumes that atomic spins moving in the same direction as a magnetic field gradient produce a phase shift that is proportional to the velocity of these spins. Previous applications of the phase contrast MRI have demonstrated that the oscillatory character of CSF flow is consistent with the cardiac cycle and respiratory rate [ 2 , 4 , 6 , 11 , 23 ]. This observation called into question some aspects of the traditional CSF bulk flow theory created by Dandy and Blacfan in 1914, which does not fully explain the genesis of communicating hydrocephalus [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous applications of the phase contrast MRI have demonstrated that the oscillatory character of CSF flow is consistent with the cardiac cycle and respiratory rate [ 2 , 4 , 6 , 11 , 23 ]. This observation called into question some aspects of the traditional CSF bulk flow theory created by Dandy and Blacfan in 1914, which does not fully explain the genesis of communicating hydrocephalus [ 6 ]. Furthermore, this theory contradicts Pascal’s law, which states that the transmantle pressure gradient cannot be the main force leading to ventricular enlargement [ 24 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to hydrodynamic theory, the main cause of hydrocephalus is the loss of brain compliance and elasticity, resulting in development of an increased transmantle pulsatile gradient between the intraventricular lumen and subarachnoid spaces. Studies have supported this theory only in small groups of adults [ 1 , 4 , 6 – 8 , 11 – 13 , 15 , 16 , 19 , 25 , 27 , 28 , 30 ]. No analogous data exists for children.…”

Section: Introductionmentioning

confidence: 99%

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The oscillatory flow of the cerebrospinal fluid in the Sylvian aqueduct and the prepontine cistern measured with phase contrast MRI in children with hydrocephalus—a preliminary report

et al. 2018

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IntroductionRecognizing patients with ventriculomegaly who are at risk of developing acute hydrocephalus presents a challenge for the clinician. The association between disturbed cerebrospinal fluid flow (CSF) and impaired brain compliance may play a role in the pathogenesis of hydrocephalus. Phase contrast MRI is a noninvasive technique which can be used to assess CSF parameters. The aim of the work is to evaluate the effectiveness of phase contrast MRI in recognizing patients at risk of acute hydrocephalus, based on measuring the pulsatile CSF flow parameters in the Sylvian aqueduct and prepontine cistern in children with ventriculomegaly.AimThe aim of the work is to characterize the parameters of cerebrospinal fluid (CSF) flow in the Sylvian aqueduct and prepontine cistern in children with ventriculomegaly with regard to patient age and symptoms. We hypothesize that the relationship between CSF flow parameters in these two regions will vary according to analyzed factors and it will allow to recognize children at risk of hydrocephalus.Materials and methodsA group of 26 children with ventriculomegaly (five girls and 21 boys) underwent phase contrast MRI examinations (Philips 3T Achieva with Q-flow integral application). Amplitudes of average and peak velocities of the CSF flow through the Sylvian aqueduct and prepontine cistern were used to calculate ratios of oscillation and peak velocities, respectively. The relationship between the oscillation coefficient, the peak velocity coefficient, and stroke volume was then assessed in accordance with age and clinical symptoms.ResultsThe peak velocity coefficient was significantly higher in patients with hyper-oscillating flow through the Sylvian aqueduct (3.04 ± 3.37 vs. 0.54 ± 0.28; p = 0.0094). Moreover, these patients tended to develop symptoms more often (p = 0.0612). No significant age-related changes were observed in CSF flow parameters.ConclusionPhase contrast MRI is a useful tool for noninvasive assessment of CSF flow parameters. The application of coefficients instead of direct values seems to better represent hemodynamic conditions in the ventricular system. However, further studies are required to evaluate their clinical significance and normal limits.

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Section: Clinical Materials and Methodologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The oscillatory flow of the cerebrospinal fluid in the Sylvian aqueduct and the prepontine cistern measured with phase contrast MRI in children with hydrocephalus—a preliminary report

et al. 2018

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“…Na Região II, quando a PIC aumenta desproporcionalmente a mudanças no volume intracraniano, a AMP aumenta em paralelo com a PIC média, portanto a RAP tente a +1, a região III não é considerado para HCF (KIM et al, 2009). (MOKRI, 2001;ANDREWS, 2006;BRADLEY JR, 2012). Embora, para a prática clínica, a afirmação de que o crânio tenha um volume fixo seja útil e quase dogmática, demonstrou-se que após a pulsação arterial, o crânio esse sofre mínimas variações em volume e essa deformação pode ser aferida através de um sensor elétrico conhecido como extensômetro (MASCARENHAS et al, 2012), que também é capaz de gerar uma curva deformação-volume muito semelhante à curva pressão-volume.…”

Section: Etiologias De Hidrocefaliaunclassified

Avaliação de método não invasivo para monitorização da pressão intracraniana em crianças e adolescentes portadores de hidrocefalia

Ballestero¹

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Palavras-chave: Hidrocefalia. Pressão Intracraniana. Hipertensão Intracraniana. Diagnóstico. Desenvolvimento tecnológico.ABSTRACT BALLESTERO, M. F. M. Evaluation of a non-invasive method to monitoring intracranial pressure in children and adolescents with hydrocephalus. 2016. 114 f. Master's Degree -Evaluation of a non-invasive method to monitoring intracranial pressure in children and adolescents with hydrocephalus.Hydrocephalus is still a challenge regarding diagnosis, treatment and monitoring in the pediatric population. Currently, treatments by ventricular or endoscopic ventriculostomies are well established. However, to date, the diagnosis of malfunctioning shunts associated with intracranial hypertension remains a problem, especially in young children and without patent fontanelles. Radiological examinations, such as ultrasonography, computerized tomography and magnetic resonance, allow only an indirect access to the intracranial pressure, whilst methods for direct assessment may present risks and therefore are rarely used in children. The aim of this study was to evaluate a noninvasive device to assess some parameters of the intracranial pressure curve in children with hydrocephalus. For this, we performed a prospective and non-experimental descriptive-analytic study. The sample consisted of children (under 18 years), including 28 patients with hydrocephalus and 28 children following routine child care (control group). Participants were divided into four groups; Group A: children with clinically compensated hydrocephalus; B: patients with hydrocephalus, but with no clinical signs of intracranial hypertension and no history of medical surgery for the treatment of hydrocephalus; C: patients with acute intracranial hypertension due to hydrocephalus, and D: children without neurological disease (control). Data were collected between 2014 and 2016, through the installation of an extracranial deformation sensor, coupled to the children's scalp, which allowed registration of non-invasive intracranial pressure curves. Data analysis was performed using Freemat® 4, Origin Pro® 8 and R® 3.1.3 software. Parameters obtained from the intracranial pressure curves were analyzed, such as "ratio P2 / P1", "classification P1 and P2" (P1> P2 or P2> P1) and "P1 slope." The results showed that P2/P1 index and "classification of P1 and P2" had a sensitivity of 80% and specificity of 100% for predicting intracranial hypertension. "P1 slope" presented no statistical difference. In summary, despite some operational limitations, this study showed a useful and non-invasive method for monitoring intracranial pressure, which was able to indicate the intracranial hypertension in children with hydrocephalus and, thus, should be further investigated for clinical applications.

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MRI of Hydrocephalus and CSF Velocity Imaging

Cited by 2 publications

References 39 publications

The oscillatory flow of the cerebrospinal fluid in the Sylvian aqueduct and the prepontine cistern measured with phase contrast MRI in children with hydrocephalus—a preliminary report

The oscillatory flow of the cerebrospinal fluid in the Sylvian aqueduct and the prepontine cistern measured with phase contrast MRI in children with hydrocephalus—a preliminary report

Avaliação de método não invasivo para monitorização da pressão intracraniana em crianças e adolescentes portadores de hidrocefalia

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