Cerebrospinal fluid flowmetry using phase-contrast MRI technique and its clinical applications

Abstract

Background and aim and aim Cine phase-contrast (PC) MRI is a useful noninvasive imaging technique in evaluating the dynamics of cerebrospinal fluid (CSF) in the evaluation, follow-up, surgical decision, and postoperative survey of certain disease processes, such as normal pressure hydrocephalus, aqueduct stenosis (AS), postendoscopic third ventriculostomy, and arachnoid cysts cases. The aim of this study was to determine the value of cardiac-gated cine-PC-MRI in characterizing CSF flow in patients with CSF flow disorders. Patients and methods The study included 30 patients with 10 persons as the control group and 20 patients who were suspected to have CSF flow abnormalities. Two imaging techniques were applied: the axial plane for flow quantification and the sagittal plane for a qualitative assessment. Results Among the 30 patients, quantitative analysis revealed the mean value to be 22 μl as the average aqueductal stroke volume in the control group. In the normal pressure hydrocephalus group, systolic velocities as well as stroke volume values were higher than those of the controls. In the AS group, lack of significant aqueductal CSF flow was noticeable. Both peak systolic and diastolic velocities were found to be statistically significantly lower in patients with AS than in the control group. In arachnoid cyst cases, CSF flow study with cine PC-MRI enables visualization of flow communication between cysts and neighboring CSF compartments. Two cases were assigned as communicating cysts and four cases were noncommunicating. Conclusion Assessment of CSF flow indicates the potentials of using PC-MRI adjunct to routine MR for the clinical study of CSF-related diseases.