scholarly journals Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

2021 ◽  
Author(s):  
Pankaj Arora ◽  
Kanica Rawat ◽  
Rajiv Azad ◽  
Kehkashan Chouhan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Phase Contrast ◽  
Flow Dynamics ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Group I ◽  
Group Ii

Abstract Objective Aim of this study is to evaluate the effect of craniospinal interventions on cerebrospinal fluid (CSF) flow hydrodynamics and study the correlation of postoperative changes in flow alteration with clinical outcome. Materials and Methods Fifty patients who underwent various craniospinal procedures were studied using conventional and phase-contrast magnetic resonance imaging (PCMRI) protocol. CSF flow quantification was performed at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels with site showing maximal alteration of CSF flow dynamics considered as the region of interest. Velocity encoding was kept at 20 cm/s. Patients with pathology atcraniovertebral junction were considered separately (group I) from others (group II) due to different flow dynamics. Follow-up scans were performed after an interval of 1 month for temporal evaluation of changes in CSF flow dynamics. Results Patients in both groups showed a significant change in peak CSF velocity postoperatively (mean change of 1.34 cm/s in group I and 0.28 cm/s in group II) with bidirectional improvement in flow on cine-phase-contrast qualitative images. Regional pain (82%) and headache (46%) were seen in most of the patients preoperatively. Postoperatively clinical symptoms improved in 59.5%, static in 26.2%, and worsened in 14.3%. In both the groups, an improvement in clinical symptomatology had significant correlation with mean changes in peak CSF velocity postoperatively (p = 0.04 in both groups). Conclusion PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively. This may have potential role in determining clinical outcome and prognosis of patients undergoing procedures in craniospinal axis.

scholarly journals Magnetic Resonance Imaging Cerebrospinal Fluid Hydrodynamics in Patients with Meningitis

2020 ◽  
Vol 10 ◽  
pp. 29
Author(s):  
Devkant Lakhera ◽  
Rajiv Kumar Azad ◽  
Sheenam Azad ◽  
Ragini Singh ◽  
Rohitash Sharma
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Stroke Volume ◽  
Peak Velocity ◽  
Viral Meningitis ◽  
Flow Dynamics ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Group Ii

Objective: The objective of the study was to evaluate the cerebrospinal fluid (CSF) flow alterations in meningitis using phase-contrast magnetic resonance imaging (PCMRI). Materials and Methods: Fifty patients with clinically confirmed or strongly suspected infectious meningitis and 20 controls were evaluated with MRI. Quantitative CSF analysis was performed at the level of cerebral aqueduct using cardiac-gated PCMRI. Velocity encoding (Venc) was kept at 20 cm/s. Patients were subdivided into Group I (patients with hydrocephalus [n = 21]) and Group II (patients without hydrocephalus [n = 29]). Results: The mean peak velocity and stroke volume in controls were 2.49 ± 0.86 cm/s and 13.23 ± 6.84 µl and in patients were 2.85 ± 2.90 cm/s and 16.30 ± 20.02 µl, respectively. A wide variation of flow parameters was noted in meningitis irrespective of the degree of ventricular dilatation. A significant difference in peak velocity and stroke volume was noted in Group II as compared to controls. Viral meningitis showed milder alteration of CSF flow dynamics as compared to bacterial and tuberculous etiologies. At a cutoff value of 3.57 cm/s in peak CSF velocity, the specificity was 100% and sensitivity was 22.7% to differentiate between viral and non-viral meningitis. Conclusion: Alteration of CSF flow dynamics on PCMRI can improve segregation of patients into viral and non- viral etiologies, especially in those in whom contrast is contraindicated or not recommended. This may aid in institution of appropriate clinical treatment.

CARDIAC-GATED PHASE-CONTRAST MAGNETIC RESONANCE IMAGING OF CEREBROSPINAL FLUID FLOW IN THE DIAGNOSIS OF IDIOPATHIC SYRINGOMYELIA

Neurosurgery ◽  
2008 ◽  
Vol 63 (6) ◽  
pp. 1139-1144 ◽  
Author(s):  
Uwe Max Mauer ◽  
Gregor Freude ◽  
Burkhardt Danz ◽  
Ulrich Kunz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Phase Contrast ◽  
Spinal Injury ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Cerebrospinal Fluid Flow ◽  
Flow Blockage ◽  
Idiopathic Syringomyelia

Abstract OBJECTIVE Syringomyelia without an obvious cause, such as a Chiari malformation, a tumor, or a spinal injury, is rare and may be associated with an arachnoid web or cyst. In the literature, conventional myelography is the diagnostic method of choice. In this retrospective study, we evaluated the diagnostic value of magnetic resonance imaging (MRI) cerebrospinal fluid (CSF) flow studies as compared with conventional myelography in patients with syringomyelia. METHODS From early 2003 to late 2006, 320 patients with syringomyelia underwent cardiac-gated phase-contrast MRI of CSF flow in the brain and spine. We assessed the presence of CSF flow blockage as well as syrinx site, shape, and size. Additional myelography was performed in 8 patients. CSF flow blockage and progressive neurological symptoms or progression of syringomyelia were indications for surgery. RESULTS Syringomyelia without an obvious cause was found in 125 patients. CSF flow blockage was detected in 33 patients. Seven of these patients underwent cyst wall resection and decompression of the subarachnoid space via a unilateral approach without laminectomy. Myelography revealed CSF flow blockage in only 2 of 8 cases. In the other 6 patients, MRI detected a blockage and surgery revealed arachnoid cysts or webs. Postoperative CSF flow studies revealed free CSF flow in all 10 surgically treated patients. In 6 of these patients, syrinx size was reduced after surgery. CONCLUSION Myelography should not be the method of choice for the diagnosis of idiopathic syringomyelia. MRI CSF flow studies were found to be more reliable.

scholarly journals Magnetic resonance imaging study of pituitary morphology in subjects homozygous and heterozygous for a null mutation of the GHRH receptor gene

2003 ◽  
pp. 427-432 ◽  
Author(s):  
HA Oliveira ◽  
R Salvatori ◽  
MP Krauss ◽  
CR Oliveira ◽  
PR Silva ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Anterior Pituitary ◽  
Receptor Gene ◽  
Brain Magnetic Resonance Imaging ◽  
Imaging Study ◽  
Resonance Imaging ◽  
Group I ◽  
Ghrh Receptor ◽  
Group Ii

OBJECTIVE: Somatotrophs represent the majority of cells in the anterior pituitary, and their numeric reduction can cause anterior pituitary hypoplasia (APH). Small numbers of patients with familial isolated GH deficiency (IGHD) due to bi-allelic mutations in the GHRH receptor (GHRHR) gene (GHRHR) have been reported to have APH. We tested if APH was present in a large cohort of patients homozygous and heterozygous for a GHRHR mutation. DESIGN: We studied pituitary morphology in adult and pediatric age subjects (8 years of age and older) belonging to a large extended Brazilian kindred with a high prevalence of IGHD due to a null GHRHR mutation. METHODS: We performed brain magnetic resonance imaging (MRI) in 38 subjects, divided into four groups: group I: normal adults (five males, four females, age 38+/-11.7 years); group II: heterozygous adults (six males, seven females, age 42.23+/-8.8 years); group III: homozygous GH-naive affected adults (three males, five females, age 41.4+/-15.0 years); group IV: homozygous affected children (three males, five females, age 11.9+/-2.5 years). Results are expressed as means+/-s.d. RESULTS: Pituitary height (mm) was not different between groups II and I (4.61+/-1.55 and 4.41+/-0.62 respectively), but it was significantly reduced in groups III (2.67+/-0.87, P<0.001) and IV (2.87+/-0.79, P<0.001) compared with group I. Pituitary volume (mm(3)) was normal in group II (417.12+/-140.86), but it was significantly reduced in groups III and IV (124.06+/-64.27 and 155.68+/-39.79 respectively vs 414.56+/-71.57; both P<0.001). The volume ratio (calculated by multiplying the pituitary volume by 1000 and dividing it by cranial volume) was significantly lower in the affected subjects (groups III and IV) (0.06+/-0.02) than in unaffected (groups I and II) (0.15+/-0.04; P<0.0001), demonstrating that APH is not due to reduction of cranial volume. CONCLUSIONS: APH is present from childhood in patients homozygous for an inactivating GHRHR mutation, but it does not occur in heterozygous subjects. In our cohort, the presence of normal anterior pituitary size by MRI rules out homozygosity for a GHRHR mutation in subjects who are 8 years of age or older.

Phase-contrast MRI Measurement of Systolic Cerebrospinal Fluid Peak Velocity (CSFVPeak) in the Aqueduct of Sylvius

1999 ◽  
Vol 90 (6) ◽  
pp. 1546-1550. ◽  
Author(s):  
Christian Kolbitsch ◽  
Michael Schocke ◽  
Ingo H. Lorenz ◽  
Christian Kremser ◽  
Fritz Zschiegner ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Intracranial Pressure ◽  
Phase Contrast ◽  
Peak Velocity ◽  
Resonance Imaging ◽  
Phase Contrast Magnetic Resonance ◽  
Aqueduct Of Sylvius ◽  
Contrast Magnetic Resonance

Background Cerebrospinal fluid (CSF) outflow to intra- and extracranial subarachnoid spaces caused by arterial inflow to the brain predominantly compensates systolic increases in cerebral blood volume. Phase-contrast magnetic resonance imaging is a new tool for noninvasive assessment of CSF displacement by measuring CSF peak velocity (CSFV(Peak)). The authors tested this new tool in an experimental human model of increased intracranial pressure and reduced cerebral capacity by means of continuous positive airway pressure (CPAP) breathing. Methods The authors investigated systolic CSFV(Peak) in the aqueduct of Sylvius in 11 awake, normocapnic (end-tidal carbon dioxide [ET(CO2)] = 40 mmHg) volunteers without CPAP and at two different CPAP levels (6 and 12 cm H2O) by means of electroencephalography-gated phase-contrast magnetic resonance imaging. Results Administration of 6 cm H2O CPAP did not change systolic CSFV(Peak) (-4.9+/-2.8 cm/s vs. control: -5.1+/-2.7 cm/s), whereas 12 cm H2O CPAP significantly reduced systolic CSFV(Peak) (-4.0+/-1.8 cm/s vs. control: -5.1+/-2.7 cm/s; P &lt; 0.05). Conclusions These findings in awake volunteers show that monitoring CSFV(Peak) in the aqueduct of Sylvius is a sensitive method for detecting even minor impairment of cerebral capacity caused by experimentally induced increases in intracranial pressure.

scholarly journals Aging Effects on Cerebral Blood and Cerebrospinal Fluid Flows

2007 ◽  
Vol 27 (9) ◽  
pp. 1563-1572 ◽  
Author(s):  
Souraya Stoquart-ElSankari ◽  
Olivier Balédent ◽  
Catherine Gondry-Jouet ◽  
Malek Makki ◽  
Olivier Godefroy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Blood Flow ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Phase Contrast ◽  
The Elderly ◽  
Elderly Group ◽  
Resonance Imaging ◽  
Aging Effects ◽  
Contrast Magnetic Resonance

Phase-contrast magnetic resonance imaging (PC-MRI) is a noninvasive reliable technique, which enables quantification of cerebrospinal fluid (CSF) and total cerebral blood flows (tCBF). Although it is used to study hydrodynamic cerebral disorders in the elderly group (hydrocephalus), there is no published evaluation of aging effects on both tCBF and CSF flows, and on their mechanical coupling. Nineteen young (mean age 27 ± 4 years) and 12 elderly (71 ± 9 years) healthy volunteers underwent cerebral MRI using 1.5 T scanner. Phase-contrast magnetic resonance imaging pulse sequence was performed at the aqueductal and cervical levels. Cerebrospinal fluid and blood flow curves were then calculated over the cardiac cycle, to extract the characteristic parameters: mean and peak flows, their latencies, and stroke volumes for CSF (cervical and aqueductal) and vascular flows. Total cerebral blood flow was ( P < 0.01) decreased significantly in the elderly group when compared with the young subjects with a linear correlation with age observed only in the elderly group ( R2 = 0.7; P = 0.05). Arteriovenous delay was preserved with aging. The CSF stroke volumes were significantly reduced in the elderly, at both aqueductal ( P < 0.01) and cervical ( P < 0.05) levels, whereas aqueduct/cervical proportion ( P = 0.9) was preserved. This is the first work to study aging effects on both CSF and vascular cerebral flows. Data showed (1) tCBF decrease, (2) proportional aqueductal and cervical CSF pulsations reduction as a result of arterial loss of pulsatility, and (3) preserved intracerebral compliance with aging. These results should be used as reference values, to help understand the pathophysiology of degenerative dementia and cerebral hydrodynamic disorders as hydrocephalus.

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