MR-Gated Intracranial CSF Dynamics: Evaluation of CSF pulsatile flow

Njemanze, Philip C.; Beck, Oscar

doi:10.1007/978-3-662-11158-1_28

Cited by 9 publications

(9 citation statements)

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“…21 The sensitivity of MRI to motion was used as an advantage in a study performed to characterize CSF motion in various parts of the neuroaxis. [22][23][24][25][26] More recent developments of the pulse sequence have allowed for the generation of MR velocity images that yield quantitative flow information. [27][28][29] During the last decade, flow-sensitive cardiac-gated PC-MRI techniques have been increasingly applied to study CSF flow dynamics both qualitatively and quantitatively.…”

Section: Discussionmentioning

confidence: 99%

Assessment of CSF Flow Dynamics Using PC‐MRI in Spontaneous Intracranial Hypotension

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Assessment of CSF Flow Dynamics Using PC‐MRI in Spontaneous Intracranial Hypotension

et al. 2012

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“…7,11,12,15,24,25,28,31,32 In a noninvasive manner, these techniques have provided us with invaluable information on a closed system such as the CSF circulation. Chiari I malformation, a condition known to be associated with CSF flow abnormalities, has been the subject of a number of these studies, both before and after decompressive surgery.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid flow dynamics study in Chiari I malformation: implications for syrinx formation

Pinna¹,

Alessandrini²,

Alfieri³

et al. 2000

FOC

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Cerebrospinal fluid (CSF) flow abnormalities are known to be present in Chiari I malformation and to underlie the origin and progression of associated syringomyelia. The incidence of syrinx formation, however, is variable for unknown reasons. The aim of this study was to investigate whether differences in CSF flow dynamics in patients with Chiari I malformation may account for the different clinical and radiological presentation. Presurgical and postsurgical phase-contrast magnetic resonance imaging investigations were prospectively conducted in 47 adult patients with symptomatic Chiari I malformation. Patients were divided into two groups according to the presence (32 cases) or absence (15 cases) of syrinx. Cerebrospinal fluid flow patterns were evaluated at four regions of interest: prebulbar cistern, foramen magnum, and the ventral and dorsal spinal subarachnoid spaces at the C-5 level. A temporal analysis of CSF flow waveforms was performed with measurement of cranial- and caudal-directed flow durations. All patients underwent a craniocervical decompressive procedure. Preoperatively, a prolonged caudal-directed (systolic) flow pattern was observed in patients with syringomyelia, as compared with normal control values obtained in 15 healthy volunteers. Conversely, a decreased systolic duration was observed in Chiari I patients who had malformation without syrinx. These trends were not statistically significant because of the considerable degree of overlap with the control values recorded in both groups. Additional comparison of the observed preoperative values obtained in patients with and those without syringomyelia indicated that the difference in systolic flow duration was significant at the ventral spinal subarachnoid space level (p = 0.003) and remarkable at the other levels, although not reaching statistical significance. Cerebrospinal fluid flow was minimal or absent at the foramen magnum (dorsal aspect) due to tonsillar herniation, precluding reliable quantitative measurement at this level. There was no evidence of communication between the fourth ventricle and syrinx in any case. Postoperatively, unobstructed CSF flow was recorded across the enlarged foramen magnum and into the artificial cisterna magna in all patients. A gradual restoration of near-normal flow patterns was observed in both groups. Inside the syrinx, fluid motion gradually tapered, no longer being detectable in 12 patients (37.5%) 1 year postsurgery. In patients with Chiari I malformation and associated syringomyelia different CSF flow patterns were demonstrated as compared with patients in whom syrinx was absent. Analysis of this study's findings supports the hypothesis that in Chiari I malformation an elongated systolic flow may prolong the condition of increased spinal subarachnoid pressure caused by the junctional obstruction, thus favoring CSF penetration into the spinal cord. It may be also proposed that a shortened systolic flow may be insufficient to maintain a hypertensive condition for enough time to induce syrinx formation.

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“…The great advantage of the MR-methods including ours is they do not require X-rays or contrast agents. This permits repetition as needed and therefore facilitates use in healthy subjects, for example for studies of the physiological CSF-dynamics [47][48][49] .…”

Section: Discussionmentioning

confidence: 98%

Clinical Validity of the MoSeSS RARE-Sequence at CSF Flow Disturbances

Orszagh¹,

Büchert²,

Schulte³

et al. 2002

Rivista di Neuroradiologia

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The development of non-invasive diagnostic methods is a matter of great importance. This paper describes Motion Sensitized Single Shot RARE Sequences (MoSeSS) as a new, non-invasive diagnostic method in CSF-flow disturbances. The range of applications and clinical validity are examined.The strongly T2-weighted RARE-sequence displays selectively unbound water. The addition of flowencoding gradients shows moving spins flow-dependently as a signal reduction. ECG-triggering enables the registration of present flow phases, and the CSF-flow can be observed as cine-mode in quasi real-time. Thirty healthy subjects and 137 patients from subcollectives with diverse CSF-flow disturbances were investigated.The MoSeSS RARE-sequence provides reliable information in occlusion or stenoses of the inner CSF-spaces and in ventriculocisternostomies. Indirect signs of shunt dysfunction are CSF turbulences which correlate in degree with the increase in CSF pressure. Determination of localization and degree of dural impairment in traumatic or postoperative pseudomeningoceles is dependent on the activity of the CSF-flow at the leak. Depending on the stage of NPH, a variably marked active flow oscillation in the aqueduct and in the third ventricle is shown. Liquorrhoea has no definable flow detectable with the MoSeSS RARE-sequence. Vascular pulsation can make differentiation of the CSF-flow from artefacts difficult near larger vessels.The MoSeSS-RARE-Sequence is a fast, non-invasive and radiation-free method, which yields valid clinical information on circulation disturbances in the inner CSF-spaces. With the cine-mode technique, CSF movements can be observed in quasi real-time. Positive enhancement of the CSF is necessary in assessing processes with an undefined, non-detectable flow. Ricevuto il 29.08.2002 Clinical Validity of the MoSeSS RARE-Sequence at CSF Flow Disturbances M. Orszagh 662The basic principle of the RARE sequence was presented by Hennig as the "MR-Myelography" method in 1986 and has since been further developed 7,8 . The flow-sensitive sequence used here is a fast and non invasive method which displays the pulsatile CSF-movements in the cranial and spinal CSF-spaces.The aim of our study was to determine the possible use of the RARE sequence and the clinical validity of the information obtained about disturbances of CSF-circulation.The flow-sensitive, ECG-triggered single-shot RARE Sequence is a combination of a flow-sensitive preparation-experiment with a RARE-Sequence as the acquisition part. The contrast reaction of the sequence can be influenced by the choice of the position of the phase-encoding zeropoint. A strong T2-weighting can thus be realized, selectively displaying unbound water. Figure 1 shows projection-images of the cranial CSF-spaces with the conventional strongly T2-weighted RARE-sequence as an example.Originally introduced as a fast MR localizationmethod and as an efficient procedure to depict lesions with a long T2, a much wider field for use of RARE is now recognized. In many hospitals, it is a stand...

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MR-Gated Intracranial CSF Dynamics: Evaluation of CSF pulsatile flow

Cited by 9 publications

References 0 publications

Assessment of CSF Flow Dynamics Using PC‐MRI in Spontaneous Intracranial Hypotension

Assessment of CSF Flow Dynamics Using PC‐MRI in Spontaneous Intracranial Hypotension

Cerebrospinal fluid flow dynamics study in Chiari I malformation: implications for syrinx formation

Clinical Validity of the MoSeSS RARE-Sequence at CSF Flow Disturbances

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