MR Imaging of Cerebrospinal Fluid Dynamics in Health and Disease

Greitz, Dan; Hannerz, Jan; Rähn, T.; Bolander, Hans; Ericsson, Anders

doi:10.1177/028418519403500302

Cited by 97 publications

(9 citation statements)

References 37 publications

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“…Seit Einfª quantitativer MR-tomographischer Flu6messungen wurden zun~ichst nur Fallbeschreibungen oder Berichte ª sehr kleine Patientengruppen publiziert, bei denen ein druckaktiver kommunizierender Hydrozephalus mit einer Zunahme der systolisch-diastohschen Flu6geschwindigkeiten bzw volumetrischen Flu8raten im Aqu~idukt assoziiert wurde [7,17,19,20]. Die Diagnose des Hydrozephalus ist in diesen Arbeiten zudem unprhzise und beruht entweder nur auf klinischen Symptomen oder morphologischen Befunden bei der konventionellen Bildgebung (Computertomographie, MR-Tomographie).…”

Section: Diskussionunclassified

“…Die Diagnose des Hydrozephalus ist in diesen Arbeiten zudem unprhzise und beruht entweder nur auf klinischen Symptomen oder morphologischen Befunden bei der konventionellen Bildgebung (Computertomographie, MR-Tomographie). Der systolische LiquorfluB im Aqu~idukt spiegelt die verst~irkte Expansion des Gehirns in Richtung auf seine innere Oberfl~iche wider [7]. Gideon [9].…”

Section: Diskussionunclassified

“…Ein anderer Ansatz schlieBt zus~itzliche Gr6gen ein, die eine pathogenetische Rolle bei der Entstehung eines kommunizierenden Hydrozephalus spielen, wie zum Beispiel die Elastizit~it und der Querschnitt der Hirngef~ige sowie der Druckgradient zwischen Hirn-oberfl~iche und Ventrikelwand (,,transmantle gradient" [7]). Auch die Suche nach anderen strategisch relevanten MeBpunkten bietet sich an.…”

Section: Diskussionunclassified

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MR-tomographische Liquorflußmessungen im Aquädukt

Hofmann¹,

Gehlert²,

Bendszus³

et al. 1999

Klin Neuroradiol

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The airo of this study was to measure oscillating CSF flow in the mesencephalic aqueduct and to obtain normal values for the systolic-diastotic flow amplitude and systolic stroke volume. 28 healthy volunteers of different age groups (10 to 75 years, median 45 years) were examined using an ECG-gated phase contrast sequence. From the oscillating flow we calculated 1. the systolic-diastolic flow amplitude and 2. the systolic stroke volume. There was a high inte¡ variability: The 25th percentile/mediard75th percentile were 0.20/0.30/0.45 ml/s for flow amplitude and 22/38/53 ~l for stroke volume. Age correlated positively with the values. The high interindividual variability of normal values indicates difficulties in sensitivity and specificity examinating disturbances of CSF dynamics.

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Section: Diskussionunclassified

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MR-tomographische Liquorflußmessungen im Aquädukt

Hofmann¹,

Gehlert²,

Bendszus³

et al. 1999

Klin Neuroradiol

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“…Phase contrast (PC)-MRI has measured increased amplitudes of fluid flow through the aqueduct during the cardiac cycle [7]. It has been shown by Wagshul et al [20] and others [10, 17, 19, 21] that the CSF latency (temporal difference in peak flow in relation to the cardiac cycle) varies throughout the cranial vault. Additionally, it has recently been established that some attributes of net CSF flow even vary with different phases of the respiratory cycle [22].…”

Section: Introductionmentioning

confidence: 99%

Opposing CSF hydrodynamic trends found in the cerebral aqueduct and prepontine cistern following shunt treatment in patients with normal pressure hydrocephalus

Hamilton

Scalzo

Baldwin

et al. 2019

Fluids Barriers CNS

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BackgroundThis study investigated cerebrospinal fluid (CSF) hydrodynamics using cine phase-contrast MRI in the cerebral aqueduct and the prepontine cistern between three distinct groups: pre-shunt normal pressure hydrocephalus (NPH) patients, post-shunt NPH patients, and controls. We hypothesized that the hyperdynamic flow of CSF through the cerebral aqueduct seen in NPH patients was due to a reduction in cisternal CSF volume buffering. Both hydrodynamic (velocity, flow, stroke volume) and peak flow latency (PFL) parameters were investigated.MethodsScans were conducted on 30 pre-treatment patients ranging in age from 58 to 88 years along with an additional 12 controls. Twelve patients also received scans following either ventriculoatrial (VA) or ventriculoperitoneal (VP) shunt treatment (9 VP, 3 VA), ranging in age from 74 to 89 years with a mean follow up time of 6 months.ResultsSignificant differences in area, velocity, flow, and stroke volume for the cerebral aqueduct were found between the pre-treatment NPH group and the healthy controls. Shunting caused a significant decrease in both caudal and cranial mean flow and stroke volume in the cerebral aqueduct. No significant changes were found in the prepontine cistern between the pre-treatment group and healthy controls. For the PFL, no significant differences were seen in the cerebral aqueduct between any of the three groups; however, the prepontine cistern PFL was significantly decreased in the pre-treatment NPH group when compared to the control group.ConclusionsAlthough several studies have quantified the changes in aqueductal flow between hydrocephalic groups and controls, few studies have investigated prepontine cistern flow. Our study was the first to investigate both regions in the same patients for NPH pre- and post- treatment. Following shunt treatment, the aqueductal CSF metrics decreased toward control values, while the prepontine cistern metrics trended up (not significantly) from the normal values established in this study. The opposing trend of the two locations suggests a redistribution of CSF pulsatility in NPH patients. Furthermore, the significantly decreased latency of the prepontine cisternal CSF flow suggests additional evidence for CSF pulsatility dysfunction.

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“…Diese Hirnexpansion wird vollständig durch den Liquorfluss aus dem Foramen magnum kompensiert und erfüllt somit die Monro-Kellie-Doktrin[7]. Greitz et al[29] konnten später diese Theorie weitestgehend mit Hilfe von magnetresonanztomographischen Untersuchungen bestätigen. Diese Theorie wurde durch Feinberg und Mark[5] an einem 0,35 Tesla Gerät mit Hilfe von MR-Geschwindigkeitsaufnahmen untermauert, wenngleich sie nicht bestätigen konnten, dass die Lateralbewegung der Thalami für die Kompression des 3.…”

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