Real‐time imaging of respiratory effects on cerebrospinal fluid flow in small diameter passageways

Töger, Johannes; Andersen, Mads Hald; Haglund, Olle; Kylkilahti, Tekla Maria; Lundgaard, Iben; Bloch, Karin Markenroth

doi:10.1002/mrm.29248

Cited by 6 publications

(15 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cardiac-related modulations have been described for decades (6-8). Recent studies suggested that also the thoracic pressure changes during the different respiratory phases in uence the CSF (9,10), arterial (11), and venous ows (4,12). Understanding the physiologic role of respiration for the blood and CSF dynamics is essential for testing the potential effect of respiratory pathologies on the brain health.…”

mentioning

confidence: 99%

Blood and cerebrospinal fluid flow oscillations measured with real-time phase-contrast MRI: breathing mode matters

Laganà

Tella

Pelizzari

et al. 2022

Preprint

View full text Add to dashboard Cite

Background. The cervical blood and cerebrospinal fluid (CSF) flow rates can be quantified with Phase-contrast (PC) MRI, routinely used for clinical studies. Previous MRI studies showed that venous and CSF flow alterations are linked to various pathological conditions. Since it is well known that, besides the heart beating, also the thoracic pump influences the blood and CSF dynamics, we studied the effect of different respiration modes on the blood and CSF flow rates using a real-time (RT)-PC prototype. Methods. Thirty healthy volunteers were examined with a 3T scanner. A RT-PC was acquired at the first cervical level to quantify the flow rates of internal carotid arteries, internal jugular veins (IJVs) and CSF. Each RT-PC was repeated three times, while the subjects were asked to breathe in three different ways for 60s each: freely (F), with a constant rate (PN) and with deep and constant respiration rate (PD). The average flow rates were computed and the power spectral density was computed for each flow rate. Low- and high-frequency peaks were identified on the spectra, their frequencies were compared to the respiratory and cardiac frequencies estimated using a thoracic band and a pulse oximeter. The area under the spectra were computed in four 0.5Hz-wide ranges, centered on the low peak, on high-frequency peak and its 2nd and 3rd harmonics, and then they were normalized by the flow rate variance. The effect of breathing patterns on average flow rates and on the normalized power was tested. Finally, the volumes displaced during inspiration were compared to those of expiration. Results. The low and high-frequency spectral peaks corresponded to the respiratory and cardiac frequencies. The average flow rate progressively decreased from F to PN to PD breathing, and the cardiac modulations were less predominant especially for the IJVs. The respiratory modulation increased with PD breathing. The average volumes displaced in the inspiratory phases were not significantly different from those of the expiratory one. Conclusions. The spectral analyses demonstrated higher respiratory modulations in the PD breathing, for the greater thoracic pump effect on the flow rates, even prevailing to the cardiac one in the IJVs.

show abstract

mentioning

confidence: 99%

Blood and cerebrospinal fluid flow oscillations measured with real-time phase-contrast MRI: breathing mode matters

Laganà

Tella

Pelizzari

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…4 Imaging results have demonstrated that cardiac, respiratory, and very low-frequency pulsations linked with vasomotor wave and/or electrophysiological activity coupled with neurovascular activity can affect the CSF-ISF dynamics. [10][11][12] Cardiac pulsation mainly affects the periarterial areas extending centrifugally to the whole brain, whereas respiratory pulsation mainly affects the perivenous regions as centripetal pluses. 10 Low-and very low-frequency pulsations propagate with unique spatiotemporal patterns and are thought to be associated with vasomotor tone variations.…”

Section: Drivers Of Fluid Movementmentioning

confidence: 99%

“…Bulk CSF Flow Dynamic Imaging CSF flow dynamics have been assessed using various MRI flow techniques, such as ultra-fast magnetic resonance encephalography, 10 real-time phase-contrast MRI, 11 real-time CSF flow imaging. 12 Specifically, ultra-fast magnetic resonance encephalography achieves a temporal resolution of 100 msec and a spatial resolution of 3 mm using a single-shot stack-of-spirals trajectory to cover three-dimensional k-space and a conjugate gradient algorithm to resolve the problem of undersampling, 20-25 times faster than conventional blood oxygen level dependent MRI. 10 Real-time phase-contrast MRI achieves a temporal resolution of 50 msec and a spatial resolution of 2.5 mm using a segmented echo-planar imaging readout module and a shared velocity encoding reconstruction algorithm.…”

Section: Dynamic-contrast-enhanced Mri Basedmentioning

confidence: 99%

“…11 To improve the spatial resolution, real-time flow imaging has achieved a temporal resolution of 168 msec and a spatial resolution of 0.6 mm using a single-slice radial gradient-echo sequence with a through-plane flow-encoding gradient, radiofrequency, and gradient spoiling. 12 Based on real-time MRI, various studies have explored effects of respiratory and neural signal on CSF flow. [10][11][12] These studies mainly focused on adults.…”

Section: Dynamic-contrast-enhanced Mri Basedmentioning

confidence: 99%

See 1 more Smart Citation

Glymphatic Imaging in Pediatrics

Li,

Lin,

Liu

et al. 2023

Magnetic Resonance Imaging

View full text Add to dashboard Cite

The glymphatic system, which facilitates cerebrospinal fluid (CSF) flow through the brain parenchyma, is important for brain development and waste clearance. Advances in imaging techniques, particularly magnetic resonance imaging, have make it possible to evaluate glymphatic structures and functions in vivo. Recently, several studies have focused on the development and alterations of the glymphatic system in pediatric disorders. This review discusses the development of the glymphatic system, advances of imaging techniques and their applications in pediatric disorders. First, the results of the reviewed studies indicate that the development of the glymphatic system is a long‐lasting process that continues into adulthood. Second, there is a need for improved glymphatic imaging techniques that are non‐invasive and fast to improve suitability for pediatric applications, as some of existing methods use contrast injection and are susceptible to motion artifacts from long scanning times. Several novel techniques are potentially feasible for pediatric patients and may be used in the future. Third, the glymphatic dysfunction is associated with a large number of pediatric disorders, although only a few have recently been investigated. In conclusion, research on the pediatric glymphatic system remains an emerging field. The preliminary applications of glymphatic imaging techniques have provided unique insight into the pathological mechanism of pediatric diseases, but mainly limited in visualization of enlarged perivascular spaces and morphological measurements on CSF volumes. More in‐depth studies on glymphatic functions are required to improve our understanding of the mechanisms underlying brain development and pediatric diseases.Level of Evidence5Technical EfficacyStage 3

show abstract

“…Cardiac-related modulations have been described for decades [ 6 – 8 ]. Recent studies suggested that the thoracic pressure changes during the different respiratory phases influence the CSF [ 9 , 10 ], arterial [ 11 ], and venous flows [ 4 , 12 ]. Understanding the physiologic role of respiration for the blood and CSF dynamics is essential for testing the potential effect of respiratory pathologies on brain health.…”

Section: Introductionmentioning

confidence: 99%

Blood and cerebrospinal fluid flow oscillations measured with real-time phase-contrast MRI: breathing mode matters

Laganà

Tella

Ferrari

et al. 2022

Fluids Barriers CNS

View full text Add to dashboard Cite

Background Cervical blood and cerebrospinal fluid (CSF) flow rates can be quantified with Phase-contrast (PC) MRI, which is routinely used for clinical studies. Previous MRI studies showed that venous and CSF flow alterations are linked to various pathological conditions. Since it is well known that, besides the heart beating, the thoracic pump influences the blood and CSF dynamics, we studied the effect of different respiration modes on blood and CSF flow rates using a real-time (RT)-PC prototype. Methods Thirty healthy volunteers were examined with a 3 T scanner. A RT-PC sequence was acquired at the first cervical level to quantify the flow rates of internal carotid arteries, internal jugular veins (IJVs) and CSF. Each RT-PC acquisition was repeated three times, while the subjects were asked to breathe in three different ways for 60 s each: freely (F), with a constant rate (PN) and with deep and constant respiration rate (PD). The average flow rates were computed, they were removed from the respective signals and integrated in the inspiratory and expiratory phases (differential volumes). Finally, the power spectral density was computed for each detrended flow rate. High- and very-high frequency peaks were identified on the spectra while their frequencies were compared to the respiratory and cardiac frequencies estimated using a thoracic belt and a pulse oximeter. The area under the spectra was computed in four 0.5 Hz-wide ranges, centered on the high-frequency peak, on very-high frequency peak and its 2nd and 3rd harmonics, and then they were normalized by the flow rate variance. The effect of breathing patterns on average flow rates, on systolic and diastolic peaks, and on the normalized power was tested. Finally, the differential volumes of inspiration were compared to those of expiration. Results The frequencies of the high- and very-high spectral peaks corresponded to the respiratory and cardiac frequencies. The average flow rate progressively decreased from F to PN to PD breathing, and the cardiac modulations were less predominant especially for the IJVs. The respiratory modulation increased with PD breathing. The average volumes displaced in the inspiratory phases were not significantly different from those of the expiratory one. Conclusions The spectral analyses demonstrated higher respiratory modulations in PD compared to free breathing, even prevailing the cardiac modulation in the IJVs, showing an increment of the thoracic pump affecting the flow rate shape.

show abstract

Real‐time imaging of respiratory effects on cerebrospinal fluid flow in small diameter passageways

Cited by 6 publications

References 61 publications

Blood and cerebrospinal fluid flow oscillations measured with real-time phase-contrast MRI: breathing mode matters

Blood and cerebrospinal fluid flow oscillations measured with real-time phase-contrast MRI: breathing mode matters

Glymphatic Imaging in Pediatrics

Blood and cerebrospinal fluid flow oscillations measured with real-time phase-contrast MRI: breathing mode matters

Contact Info

Product

Resources

About