Role of MRI CSF Flowmetry in Evaluation of Hydrocephalus in pediatric patients with Correlation between thin cuts T2, heavy T2 and Phase contrast.

Abstract

Background and Aim: flow-sensitive MRI techniques have been applied to quantitatively and qualitatively assess CSF flow dynamics to discriminate between communicating and noncommunicating hydrocephalus. So, we aimed to Correlate between thin cuts T2 ,3D-heavy T2 {CISS, sampling perfection with application-optimized contrasts using different flip angle evolutions (SPACE) with variable flip angle mode (VFAM) & constant angle} & phase contrast (PC) Sequences in pediatric hydrocephalus Patient & methods: 20 Patients with age below 18yrs old with evidence of hydrocephalic changes by clinical examination and by previous U/S,CT or MR scan with ventriculomegaly were included. 2D-T2-TSE, 3D-heavy T2 & PC-MRI were analyzed qualitatively by evaluating the capabilities of visualization of the obstructive pathology, overall image quality, severity of artifacts, and delineation of the CSF pathways. Results:showed that 3D heavily T2WI were superior to T2-TSE, 3D-SPACE showed fewer artifacts than 3D-CISS or T2-TSE sequences. 3D-SPACE VFAM is considered as a highly accurate alternative to PC-MRI for physiological and morphological evaluation of aqueductal patency compared to T2-TSE. Conclusion: 3D heavily T2 sequences are necessary for the assessment of CSF pathways in patients with hydrocephalus when compared with T2-TSE. 3D-SPACE VFAM is considered as a highly accurate alternative to PC-MRI for physiological and morphological evaluation of aqueductal patency.