CSF flowmetry: an innovative technique in diagnosing normal pressure hydrocephalus

Senger, Krishna Pratap Singh; Singh, Ram Kumar; Singh, Ajay Kumar; Singh, Ankita; Dashottar, Sunita; Sharma, Vivek; Mishra, Atul

doi:10.18203/2349-3933.ijam20171996

Cited by 10 publications

(8 citation statements)

References 7 publications

(8 reference statements)

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“…After sequence acquisition, images are retrieved in sets of three different contrasts for each plane: re-phased image (magnitude of flow compensated signal), phase image (phase of difference signal), and magnitude (magnitude of difference signal). Since it reflects the phase shift, the phase image is more sensitive to CSF flow detection than the magnitude image [3, 4, 9]. The acquisitions are synchronized with the cardiac cycle generating images with velocity information providing the ability to calculate stroke volume, mean velocity, and peak flow in systole and diastole.…”

Section: Mri Protocolmentioning

confidence: 99%

The value of CSF flow studies in the management of CSF disorders in children: a pictorial review

2019

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CSF flow disorders are frequently encountered in children. The advent of MR technology with the emergence of new pulse sequences allowed better understanding of CSF flow dynamics. In this pictorial review, we aim to conduct a comprehensive review of the MR protocol used to study CSF flow disorders and to discuss the utility of each pulse sequence in the adopted protocol. We will focus on the key anatomical structures that should be examined to differentiate hydrocephalus form ventricular dilatation ex-vacuo. The MR features of obstructive and communicating hydrocephalus will be discussed, in addition to the manifestations of CSF disorders associated with posterior fossa malformations (Dandy-Walker malformation, Chiari, and Blake’s pouch cyst). Moreover, the value of MRI in the assessment of patients following interventional procedures (ventriculoperitoneal shunt and third ventriculostomy) will be addressed.Electronic supplementary materialThe online version of this article (10.1186/s13244-019-0686-x) contains supplementary material, which is available to authorized users.

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Section: Mri Protocolmentioning

confidence: 99%

The value of CSF flow studies in the management of CSF disorders in children: a pictorial review

2019

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“…Senger KPS et al, 2020 [12] also reported that stroke volume of >42 microL/cycle is shown to predict good response after CSF shunting.…”

Section: Discussionmentioning

confidence: 97%

Prognostic Value of MRI-CSF Flowmetry for Shunt Responsiveness in Patients with Idiopathic Normal Pressure Hydrocephalus

MAGDY¹,

YOUSSEF²,

EL-DIN

2022

The Medical Journal of Cairo University

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Background: Idiopathic normal pressure hydrocephalus (iNPH) is considered a treatable cause of dementia. MRI-CSF flow study is a non-invasive investigation for qualitative and quantitative CSF flow analysis to be used for the diagnosis of normal pressure hydrocephalus (NPH). The degree of clinical improvement of NPH symptoms post CSF diversion and shunting; was better in patients with higher pre-operative CSF stroke volume; allowing MR-CSF flowmetry to be a promising prognostic tool. Aim of Study:To evaluate the prognostic value of MRI-CSF flowmetry for shunt responsiveness in patients with idiopathic normal pressure hydrocephalus and its usefulness as a predictor of post CSF diversion favorable outcome.Patients and Methods: Our study is prospective. 38 patients with clinical diagnosis of iNPH, ventriculomegaly and hyper dynamic CSF flow on PC MRI were included in our study. We used two protocols of PC MRI-CSF flowmetry examination; one assessing CSF flow dynamics qualitatively using a sagittal plane and one quantitatively using an axial plane perpendicular to the aqueduct. All patients underwent ventriculo-peitoneal shunt (VPS). Patients were followed up after shunting surgery for average 10 months at neurology and neurosurgery outpatient clinics for improvement of clinical symptoms & categorized into well responsive to shunt or not.Results: We found that aqueductal CSF stroke volume (>42 microL) shows sensitivity of about (93.4%) & specificity of about (75.1%) with total accuracy of about (89.6%) in predicting shunt responsiveness and favorable outcome in iNPH patients.Conclusion: MRI-CSF flowmetry is a promising noninvasive prognostic tool for iNPH. It had a high predictive value for shunt responsiveness. Our study enhances the utility of PC MRI-CSF flowmetry in selection of iNPH patients who are likely to benefit from VPS (shunt responsive); thus reducing the rate of unnecessary previously used invasive procedures as external lumbar drainage.

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“…Phase contrast MRI CSF flowmetry can be used for qualitative and quantitative assessment of CSF flow abnormality in all the previously mentioned neurological condition [18]. Many parameters have been used for assessment of CSF flow by PC MRI including flow, and velocity parameter, stroke volume, peak systolic velocity, mean systolic velocity, forward flow volume, and backward flow volume [10].…”

Section: Discussionmentioning

confidence: 99%

“…Normal pressure hydrocephalus is one of the few treatable causes of dementia, but it is difficult to accurately differentiate it from BA. PC MRI provides a non-invasive tool for diagnosis of NPH and differentiates it from brain atrophy [10].…”

Section: Discussionmentioning

confidence: 99%

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MRI CSF flowmetry in evaluation of different neurological diseases

Ahmad

Salama

Al-Haggar

2021

Egypt J Radiol Nucl Med

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Background Phase contrast MR imaging is a rapid and non-invasive technique which is sensitive in diagnosis and follow-up of different neurological diseases that cause CSF flow abnormality. MRI CSF flowmetry will be currently assessed in different neurological diseases that may cause CSF flow abnormalities. Results This study includes 39 patients with their ages ranging from 1 to 65 years; they were referred from the neurology department, with nine individuals of matched age and sex as a control group. Based on clinical history and conventional MRI, patients were subdivided into five subgroups; normal pressure hydrocephalus (NPH), hydrocephalus, idiopathic intracranial hypertension (IIH), brain atrophy (BA), and Chiari malformation type I (CM-I). All patients and control were subjected to MRI CSF flowmetry evaluation with stress on peak diastolic velocity (PDV), peak systolic velocity (PSV), stroke volume (SV), and maximum velocity (Vmax). PDV, PSV, and SV were found significantly higher in NPH, CM-I, and hydrocephalus compared to control (4.2, 4.96, and 83.23 for NPH; 3.95, 4.93, and 37.38 for CM-I; and 4.2, 5.6, and 125 in hydrocephalus versus 2.11, 2.73, and 75.33 in control, respectively; P = 0.0004, 0.0008, and 0.0009 for NPH; 0.03, 0.003, and 0.06 for CM-I; and 0.0005, 0.0002, and 0.0003, respectively). On the other hand, patients with BA showed significantly lower values (1.37, 1.66, and 1.53, respectively) compared to control (P = 0.001, 0.001, and 0.004, respectively). Conclusion MRI CSF flowmetry provides an easy, accurate, and non-invasive method for diagnosis of different neurological diseases that cause CSF flow abnormality. Moreover, this diagnostic modality could be helpful in selecting the therapeutic option.

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CSF flowmetry: an innovative technique in diagnosing normal pressure hydrocephalus

Cited by 10 publications

References 7 publications

The value of CSF flow studies in the management of CSF disorders in children: a pictorial review

The value of CSF flow studies in the management of CSF disorders in children: a pictorial review

Prognostic Value of MRI-CSF Flowmetry for Shunt Responsiveness in Patients with Idiopathic Normal Pressure Hydrocephalus

MRI CSF flowmetry in evaluation of different neurological diseases

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