Abstract

ObjectivesTo assess the influence of age and sex on 10 cerebrospinal fluid (CSF) flow dynamics parameters measured with an MR phase contrast (PC) sequence within the cerebral aqueduct at the level of the intercollicular sulcus.Materials and Methods128 healthy subjects (66 female subjects with a mean age of 52.9 years and 62 male subjects with a mean age of 51.8 years) with a normal Evans index, normal medial temporal atrophy (MTA) score, and without known disorders of the CSF circulation were included in the study. A PC MR sequence on a 3T MR scanner was used. Ten different flow parameters were analyzed using postprocessing software. Ordinal and linear regression models were calculated.ResultsThe parameters stroke volume (sex: p < 0.001, age: p = 0.003), forward flow volume (sex: p < 0.001, age: p = 0.002), backward flow volume (sex: p < 0.001, age: p = 0.018), absolute stroke volume (sex: p < 0.001, age: p = 0.005), mean flux (sex: p < 0.001, age: p = 0.001), peak velocity (sex: p = 0.009, age: p = 0.0016), and peak pressure gradient (sex: p = 0.029, age: p = 0.028) are significantly influenced by sex and age. The parameters regurgitant fraction, stroke distance, and mean velocity are not significantly influenced by sex and age.ConclusionCSF flow dynamics parameters measured in the cerebral aqueduct are partly age and sex dependent. For establishment of reliable reference values for clinical use in future studies, the impact of sex and age should be considered and incorporated.

Highlights

  • Cerebrospinal fluid is a water-like transparent fluid produced mainly in the choroid plexus in the ventricles of the brain and in the interstitium and the meninges

  • To assess the influence of age and sex on 10 cerebrospinal fluid (CSF) flow dynamics parameters measured with an MR phase contrast (PC) sequence within the cerebral aqueduct at the level of the intercollicular sulcus

  • CSF flow dynamics parameters measured in the cerebral aqueduct are partly age and sex dependent

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Summary

Introduction

Cerebrospinal fluid is a water-like transparent fluid produced mainly in the choroid plexus in the ventricles of the brain and in the interstitium and the meninges. When passing through the cerebral aqueduct CSF flow is not static but rather oscillatory depending on breathing and heart beat (Markenroth Bloch et al, 2018). In a previous study, age and sex (yet not height) have been described to significantly impact different CSF flow dynamics parameters in the aqueduct (Schmid Daners et al, 2012). In our study we aimed at reinvestigating sex and age dependencies of 10 CSF flow dynamics parameters in 128 healthy subjects of varying age (ranging from 17 to 88 years) within the cerebral aqueduct using a PC MR sequence (Wåhlin et al, 2012; Najafi et al, 2018)

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