Pre-Mammillary Endoscopy: Evaluation with Phase Contrast Cine-MR Imaging

Abstract

Cerebrospinal fluid (CSF) waveform evaluation through the use of Phase Contrast Cine-Magnetic Resonance (MR) imaging after pre-mammillary endoscopic ventriculostomy. A descriptive study of 21 patients, 13 men and 8 women (average age 36), submitted to pre-mammillary endoscopic ventriculostomy for treatment of non-communicating hydrocephalus. Evaluation of CSF was accomplished using a Siemens System (1.5 Siemens Magnetom 63SP) with continuous data recording and retrospective cardiac gating. The quantitative study was performed with in-plane and through-plane spatial resolution: sagittal and transverse 2D FISP (70,100 TR/13,16 TE, flip angle 15°), recording the mean velocity at the level of aqueduct, pontine cistern and CSF space in front of C1 as well as mean and maximum velocities and stroke volume at the ventriculostomy site. A Pearson correlation (P<0.001) is present between diastolic and systolic stroke volumes not only at the site the ventriculostomy but also among stroke volumes and velocities in the pontine cistern and aqueduct. The only level where no statistical correlation was found between stroke volumes and velocities was the CSF space before the first cervical vertebral body (C1). Analysis with Phase Contrast Cine-MR imaging shows that pre-mammillary endoscopic ventriculostomy is efficient for restoring cerebrospinal fluid pulsatile waveform.