MRI CSF flowmetry in evaluation of different neurological diseases

Abstract

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.

The Role of Phase-Contrast MRI in Diagnosing Cerebrospinal Fluid Flow Abnormalities

“…Furthermore, phase-contrast MRI examinations conducted on NPH patients revealed significantly greater values in all parameters compared to the control group, consistent with findings by Ahmed et al [15] and Giner et al [16]. The utility of this technique in hydrocephalus classification, particularly in distinguishing communicating from non-communicating hydrocephalus, was underscored.…”

Quantifying cerebrospinal fluid dynamics: A review of human neuroimaging contributions to CSF physiology and neurodegenerative disease

“…Alongside its application to neurodegenerative disease, PCC MRI has been utilized to study the impact of CSF flow on many neurologic disorders including iNPH, Chiari malformation, intracranial hyper and hypotension, and obstructive hydrocephalus. In one wide-ranging study, a group of 39 patients stratified along five subgroups (iNPH, hydrocephalus, idiopathic intracranial hypertension, brain atrophy, and Chiari I malformation type) were examined using cardiac-gated sagittal PCC MR image ( Ahmad et al, 2021 ). In the iNPH group, PCC MRI at the level of the cerebral aqueduct found hyperdynamic CSF flow ( Ahmad et al, 2021 ).…”

“…In one wide-ranging study, a group of 39 patients stratified along five subgroups (iNPH, hydrocephalus, idiopathic intracranial hypertension, brain atrophy, and Chiari I malformation type) were examined using cardiac-gated sagittal PCC MR image ( Ahmad et al, 2021 ). In the iNPH group, PCC MRI at the level of the cerebral aqueduct found hyperdynamic CSF flow ( Ahmad et al, 2021 ). Additionally, authors were able to use the PCC MRI data to successfully diagnose the exact cause of obstructive hydrocephalus ( Ahmad et al, 2021 ).…”

“…In the iNPH group, PCC MRI at the level of the cerebral aqueduct found hyperdynamic CSF flow ( Ahmad et al, 2021 ). Additionally, authors were able to use the PCC MRI data to successfully diagnose the exact cause of obstructive hydrocephalus ( Ahmad et al, 2021 ). Across all pathological subgroups, PCC MRI provided novel and useful information on CSF flow parameters, confirming the technique’s effectiveness in the diagnosis and prognosis of a diverse cohort of neurological problems.…”

Fluids and flows in brain cancer and neurological disorders

“…Previous animal studies have reported AQP1 expression is closely related to raised ICP through increased CSF production (Stiebel-Kalish et al, 2013), however there is no direct evidence that AQP1 plays the same role in humans. Blood clotting abnormalities Traumatic brain injury N/A # (Xiong et al, 2014) Idiopathic intracranial hypertension N/A Acute patients ", Chronic patients # (Akay et al, 2015;Belal et al, 2020) Normal pressure hydrocephalus N/A " (Ahmad et al, 2021;Bradley, 2015;Tawfik et al, 2017) Ischemic stroke N/A " (Dhar et al, 2020) Post-traumatic syringomyelia N/A # (Yeo et al, 2017) have been reported in IIH patients and may indirectly explain the impaired CSF drainage (Sussman et al, 1997). Moreover, in a recent study female IIH patients present increased hormone levels such as serum testosterone, CSF testosterone and androstenedione (O'Reilly et al, 2019).…”