The application of integrated MRI CSF flowmetry in the diagnosis and treatment of CSF dynamic changes in hydrocephalus patients: a systematic review

Abstract

Background: CSF has contributed to the growth of brain development during the time of evolution and later protects against external trauma. Idiopathic normal pressure hydrocephalus (iNPH) is known as an aberration of intracranial hydrodynamics resulting in the accumulation of CSF endo-ventricular. The use of phase-contrast (PC) MRI is proven effective in assessing the communication of arachnoid cyst and subarachnoid CSF spaces. The CSF flow MRI has been found to show efficacy in differentiation between the communicating and non-communicating hydrocephalus for localizing obstruction levels in obstructive hydrocephalus and later providing important information concerning the preoperative evaluation of NPH, along with the differential diagnosis and the prediction of the related advantages from surgery and post-operative follow-up. Hence, the present study aimed for analyzing the role of MRI CSF flowmetry in the evaluation of patients with suspected hydrocephalus. Method: The role of MRI CSF flowmetry in the evaluation of patients with suspected hydrocephalus was undertaken by conducting a systematic literature review. The current review was reported as required reporting features for systematic reviews and meta-analysis statements (PRISMA). The systematic literature review included a total of 22 studies that analyzed the various applications of MRI CSF flowmetry in the medical field, mainly focusing on the use of MRI CSF flowmetry in the evaluation of patients with suspected hydrocephalus. Results: The result mainly included the identification of the CSF flow by integrating the PC MRI technique and the aqueduct-CSF flow rate was detected accurately showing as statistically significant in diagnosis of NPH. Evaluating the peak velocities and aqueductal stroke volume (ASV) showed a significant increase among hydrocephalus patients. Conclusion: The condition of hydrocephalus makes the ventricular size increase and eventually puts pressure on the brain due to excess accumulation of fluid while blocking the CSF flow after it exits ventricles. Currently, many imaging techniques are available for the detection of hydrocephalus that study the CSF flow dynamics and its related parameters. Among them, the MRI technique is the most reliable, rapid, and most importantly, a non-invasive method for the quantitative measurement of CSF flow rate and intracranial pulsations. Keywords: Intracranial pressure, Magnetic resonance imaging (MRI), MRI CSF Flowmetry, Neurological disorder, CSF dynamics