MR-Intracranial Pressure (ICP): A Method to Measure Intracranial Elastance and Pressure Noninvasively by Means of MR Imaging: Baboon and Human Study

Alperin, Noam; Lee, Sang H.; Loth, Francis; Raksin, P.B.; Lichtor, Terry

doi:10.1148/radiology.217.3.r00dc42877

Cited by 283 publications

(269 citation statements)

References 26 publications

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“…The LV volumetric change is expected to be a fraction of the intracranial volumetric change. Thus the LV volumetric change of 0.147 Ϯ 0.084 mL we measured in normal subjects is consistent with the intracranial volumetric change of 0.34 -1.3 mL measured by Alperin et al (3). The temporal relationship between the CSF oscillatory flow directions at the AS or V3, and the LV volumetric change, indicates that the LV motion plays an important role in the CSF flow.…”

Section: Discussionsupporting

confidence: 91%

“…The temporal relationship between the LV volumetric change and the basilar artery blood flow rate (Fig. 5) measured by us shows a good agreement with the temporal relationship between the intracranial volumetric change and the transcranial arterial inflow rate measured by Alperin et al (3). The LV volumetric change is expected to be a fraction of the intracranial volumetric change.…”

Section: Discussionsupporting

confidence: 89%

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Dynamics of lateral ventricle and cerebrospinal fluid in normal and hydrocephalic brains

Zhu

Xenos

Linninger

et al. 2006

Magnetic Resonance Imaging

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Purpose: To develop quantitative MRI techniques to measure, model, and visualize cerebrospinal fluid (CSF) hydrodynamics in normal subjects and hydrocephalic patients. Materials and Methods:Velocity information was obtained using time-resolved (CINE) phase-contrast imaging of different brain regions. A technique was developed to measure the change of lateral ventricle (LV) size. The temporal relationships between the LV size change, CSF movement, and blood flow could then be established. The data were incorporated into a first-principle CSF hydrodynamic model. The model was then used to generate specific predictions about CSF pressure relationships. To better-visualize the CSF flow, a color-coding technique based on linear transformations was developed that represents the magnitude and direction of the velocity in a single cinematic view. Results:The LV volume change of the eight normal subjects was 0.901 Ϯ 0.406%. Counterintuitively, the LV decreases as the choroid plexus expands, so that they act together to produce the CSF oscillatory flow. The amount of oscillatory flow volume is 21.7 Ϯ 10.6% of the volume change of the LV from its maximum to its minimum. Conclusion:The quantification and visualization techniques, together with the mathematical model, provide a unique approach to understanding CSF flow dynamics.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Dynamics of lateral ventricle and cerebrospinal fluid in normal and hydrocephalic brains

Zhu

Xenos

Linninger

et al. 2006

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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“…6,7,9 In brief, blood and CSF volumetric flow rates into and out from the cranium are obtained using the pulsatility-based segmentation method for the measurement of pulsatile flow.…”

Section: Csf Flow and Cord Motionmentioning

confidence: 99%

“…Maximal change in pressure is derived from changes in the CSF pressure gradient calculated using the Navier-Stokes relationship between pressure gradients and CSF velocities. 9,19 Total cerebral blood inflow is calculated by the summation of flow through the internal carotid and vertebral arteries, and venous outflow is calculated by the summation of the flow through the internal jugular veins and secondary veins (e.g., epidural and vertebral) if present.…”

Section: Intracranial Hydrodynamics Measuresmentioning

confidence: 99%

Magnetic resonance imaging–based measures predictive of short-term surgical outcome in patients with Chiari malformation Type I: a pilot study

Alperin¹,

Loftus²,

Bagci³

et al. 2017

SPI

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OBJECTIVE This study identifies quantitative imaging-based measures in patients with Chiari malformation Type I (CM-I) that are associated with positive outcomes after suboccipital decompression with duraplasty. METHODS Fifteen patients in whom CM-I was newly diagnosed underwent MRI preoperatively and 3 months postoperatively. More than 20 previously described morphological and physiological parameters were derived to assess quantitatively the impact of surgery. Postsurgical clinical outcomes were assessed in 2 ways, based on resolution of the patient's chief complaint and using a modified Chicago Chiari Outcome Scale (CCOS). Statistical analyses were performed to identify measures that were different between the unfavorable- and favorable-outcome cohorts. Multivariate analysis was used to identify the strongest predictors of outcome. RESULTS The strongest physiological parameter predictive of outcome was the preoperative maximal cord displacement in the upper cervical region during the cardiac cycle, which was significantly larger in the favorable-outcome subcohorts for both outcome types (p < 0.05). Several hydrodynamic measures revealed significantly larger preoperative-to-postoperative changes in the favorable-outcome subcohort. Predictor sets for the chief-complaint classification included the cord displacement, percent venous drainage through the jugular veins, and normalized cerebral blood flow with 93.3% accuracy. Maximal cord displacement combined with intracranial volume change predicted outcome based on the modified CCOS classification with similar accuracy. CONCLUSIONS Tested physiological measures were stronger predictors of outcome than the morphological measures in patients with CM-I. Maximal cord displacement and intracranial volume change during the cardiac cycle together with a measure that reflects the cerebral venous drainage pathway emerged as likely predictors of decompression outcome in patients with CM-I.

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“…If the CSF flow is also subtracted from the A-V flow, the intracranial volume change (ICVC) can be obtained similarly. This method is used to measure the intracranial compliance and pressure from the ratio of volume and pressure changes that occur during the cardiac cycle [2].…”

Section: Introductionmentioning

confidence: 99%

MRI Measurements of Craniospinal and Intracranial Volume Change in Healthy and Head Trauma Cases

Alperin¹,

Kadkhodayan²,

Varadarajalu³

et al. 2001

PsycEXTRA Dataset

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The volumes of the intracranial space and the craniospinal system as a whole change during the cardiac cycle. These volume changes are caused by the pulsatile arterial inflow to the cranium, venous outflow from the cranium, and cerebrospinal fluid (CSF) flow that oscillates back and forth between the cranium and the spinal canal. The volume changes can be measured accurately and reproducibly using a dynamic, motion-sensitive MRI technique [1]. It appears intuitive that the volume change of the entire craniospinal system (CSVC) should be greater than the intracranial volume change (ICVC). However, since they exhibit varying temporal information, CSVC can be smaller than ICVC. In the present study, these volume changes were measured in healthy humans and trauma cases. In the trauma cases, it was found that CSVC was smaller than ICVC. The cause was found to be increased pulsatility in the venous flow channels. It is suspected that the resulting relationship between ICVC and CSVC is related to the incidence of trauma, and perhaps CSVC being smaller than ICVC could serve as an indicator. The craniospinal system consists of two subcompartments, the intracranial space (skull) and the spinal canal. Cerebrospinal fluid (CSF) oscillates back and forth between these two subcompartments. The system can be modeled with arterial inflow and venous outflow. During systole, arterial blood rushes into the cranium, forcing the CSF out into the spinal canal. As the blood drains through venous channels during diastole, the CSF refills the cranium. Since this is a closed system, the entire craniospinal system volume change (CSVC) can be found by subtracting the venous (V) outflow from the arterial (A) inflow and examining the peak to peak change in the integral of A-V over one cardiac cycle. If the CSF flow is also subtracted from the A-V flow, the intracranial volume change (ICVC) can be obtained similarly. This method is used to measure the intracranial compliance and pressure from the ratio of volume and pressure changes that occur during the cardiac cycle [2]. II. METHODArterial, venous, and CSF flows were measured using a dynamic, motion-sensitive MRI technique [1]. This technique results in cross-sectional images of velocity. This means that the pixel values are proportional to the velocity of the particles. Gray areas are static; black represents velocity in one direction, while white represents velocity in the other. In the sample image (Fig. 2), the large white spot is a jugular vein carrying blood away from the cranium while the large black spots are carotid and vertebral arteries carrying blood into the cranium. The flow rates can be obtained from the images of velocity by integrating velocity values over the lumen area. This sample image is actually 1 of 32 images that are taken per cardiac cycle. Flow rates derived from each image are plotted together to create the flow waveforms in Fig. 3 that illustrate changing flow during one heart beat. Regular biases in the MRI velocity measurements that result from basel...

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MR-Intracranial Pressure (ICP): A Method to Measure Intracranial Elastance and Pressure Noninvasively by Means of MR Imaging: Baboon and Human Study

Abstract: MR imaging-derived elastance index correlates with ICP over a wide range of ICP values. The sensitivity of the technique allows differentiation between normal and elevated ICP.

Cited by 283 publications

References 26 publications

Dynamics of lateral ventricle and cerebrospinal fluid in normal and hydrocephalic brains

Dynamics of lateral ventricle and cerebrospinal fluid in normal and hydrocephalic brains

Magnetic resonance imaging–based measures predictive of short-term surgical outcome in patients with Chiari malformation Type I: a pilot study

MRI Measurements of Craniospinal and Intracranial Volume Change in Healthy and Head Trauma Cases

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