Phase-Contrast Cine Mr Imaging of Normal Aqueductal CSF Flow

1994 ◽  
Vol 35 (2) ◽  
pp. 123-130 ◽  
Author(s):  
F. Barkhof ◽  
M. Kouwenhoven ◽  
P. Scheltens ◽  
M. Sprenger ◽  
P. Algra ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Phase Contrast ◽  
Volume Averaging ◽  
Cortical Atrophy ◽  
Csf Flow ◽  
Caudal Direction ◽  
Cine Mr ◽  
Flow Void ◽  
Phantom Studies ◽  
Cine Phase Contrast

Cine phase-contrast MR imaging was used to study pulsatile CSF flow in the aqueduct in 11 young controls (mean age 30 years) and 9 old controls (mean age 69 years). A high-resolution gradient echo technique and an oblique imaging plane, perpendicular to the aqueduct, was used to avoid volume averaging. Phantom studies confirmed that the technique was accurate. Aqueductal velocity and flux in old controls was higher than in young controls, but the differences were not significant. For all controls together, the averaged peak velocity was 4.2 ± 1.5 cm/s in rostral and −7.8 ± 4.9 cm/s in caudal direction; for the flux it was 0.16 ± 0.10 cm3/s in rostral and −0.29 ± 0.19 cm3/s in caudal direction. Phase-contrast measurements were significantly related to flow-void on modulus MR images, but not with ventricular size or cortical atrophy. The present technique avoids underestimation of aqueductal flow, and therefore reveals higher aqueductal velocity and flux values than previous studies. Factors other than age or atrophy seem to determine aqueductal CSF flow.

Phase-contrast cine MR imaging of normal aqueductal CSF flow

1994 ◽  
Vol 35 (2) ◽  
pp. 123-130 ◽  
Author(s):  
Frederik Barkhof ◽  
M. Kouwenhoven ◽  
P. Scheltens ◽  
M. Sprenger ◽  
P. Algra ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Phase Contrast ◽  
Csf Flow ◽  
Cine Mr

Toward a rational treatment of Chiari I malformation and syringomyelia

2000 ◽  
Vol 8 (3) ◽  
pp. 1-10 ◽  
Author(s):  
Richard G. Ellenbogen ◽  
Rocco A. Armonda ◽  
Dennis W. W. Shaw ◽  
H. Richard Winn
Keyword(s):  
Mr Imaging ◽  
Posterior Fossa ◽  
Phase Contrast ◽  
Chiari I Malformation ◽  
Pathological Findings ◽  
Csf Flow ◽  
Rational Treatment ◽  
Flow Profiles ◽  
Cine Mr ◽  
Chiari I

In patients with Chiari I malformation with and without associated syringomyelia, aberrant cerebrospinal fluid (CSF) dynamics and a spectrum of posterior fossa pathological findings are demonstrated. In this study, the authors test the validity of using prospective cardiac-gated phase-contrast cine-mode magnetic resonance (MR) imaging to define the malformation, delineate its pathophysiology, and assist in implementing a rational treatment plan. Eighty-five cases were prospectively analyzed using cine MR imaging. Sixty-five patients, adults and children, with symptomatic Chiari malformation, with and without syringomyelia, were surgically treated from 1990 to 1999. All patients underwent pre- and postoperative cine MR evaluation. Ten patients were treated after a previous surgical procedure had failed. To establish CSF flow characteristics and normative CSF profiles, 20 healthy volunteers were examined. Compared with normal volunteers, in Chiari I malformation patients with and without syringomyelia, uniformly abnormal craniocervical junction CSF flow profiles were revealed. After intradural exploration, nearly all patients with Chiari I malformation experienced clinical improvement and CSF flow profiles, paralleling those of normal volunteers, were shown. In all patients in whom treatment had failed, abnormal preoperative CSF flow profiles, which correlated with suspected physiological abnormalities and the pathological findings noted at reoperation, were demonstrated. Symptomatic Chiari I malformation is a dynamic process characterized by the impaction of the hindbrain in an abnormal posterior fossa. This compression obstructs the normal venting of CSF in and out of the craniocervical sub-arachnoid space, throughout the cardiac cycle. Therefore, decompression or enlargement of the posterior fossa to establish normal CSF pathways should be the primary goal of surgical intervention. Aberrant CSF flow appears to be only one aspect of the pathological condition found in patients with Chiari I malformation. Arachnoid scarring in the posterior fossa and selective vulnerability of the spinal cord may also be factors in the pathogenesis and maintenance of associated syringomyelia. Phase-contrast cine MR imaging is a useful tool in defining physiological and anatomical problems in patients with Chiari I and syringomyelia, and it can help guide an appropriate primary or salvage surgical therapy.

scholarly journals Cough-Associated Headache in Patients with Chiari I Malformation: CSF Flow Analysis by Means of Cine Phase-Contrast MR Imaging

2011 ◽  
Vol 32 (4) ◽  
pp. 739-742 ◽  
Author(s):  
R.A. Bhadelia ◽  
E. Frederick ◽  
S. Patz ◽  
P. Dubey ◽  
S.H. Erbay ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Phase Contrast ◽  
Flow Analysis ◽  
Chiari I Malformation ◽  
Csf Flow ◽  
Chiari I ◽  
Cine Phase Contrast

Phase-contrast cine MR imaging of normal aqueductal CSF flow

1994 ◽  
Vol 35 (2) ◽  
pp. 123-130 ◽  
Author(s):  
Frederik Barkhof ◽  
M. Kouwenhoven ◽  
P. Scheltens ◽  
M. Sprenger ◽  
P. Algra ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Phase Contrast ◽  
Csf Flow ◽  
Cine Mr

scholarly journals CSF Flow Quantification of the Cerebral Aqueduct in Normal Volunteers Using Phase Contrast Cine MR Imaging

2004 ◽  
Vol 5 (2) ◽  
pp. 81 ◽  
Author(s):  
Jeong Hyun Lee ◽  
Ho Kyu Lee ◽  
Jae Kyun Kim ◽  
Hyun Jeong Kim ◽  
Ji Kang Park ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Phase Contrast ◽  
Flow Quantification ◽  
Cerebral Aqueduct ◽  
Csf Flow ◽  
Normal Volunteers ◽  
Cine Mr

scholarly journals Standard and cardiac-gated phase-contrast magnetic resonance imaging in the clinical course of patients with Chiari malformation Type I

2011 ◽  
Vol 31 (3) ◽  
pp. E5 ◽  
Author(s):  
Uwe Max Mauer ◽  
Andreas Gottschalk ◽  
Carolin Mueller ◽  
Linda Weselek ◽  
Ulrich Kunz ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Chiari Malformation ◽  
Phase Contrast ◽  
Foramen Magnum ◽  
Central Canal ◽  
Type I ◽  
Csf Flow ◽  
Chiari Malformation Type I ◽  
Cerebrospinal Fluid Flow ◽  
Contrast Magnetic Resonance

Object The causal treatment of Chiari malformation Type I (CM-I) consists of removing the obstruction of CSF flow at the level of the foramen magnum. Cerebrospinal fluid flow can be visualized using dynamic phase-contrast MR imaging. Because there is only a paucity of studies evaluating CSF dynamics in the region of the spinal canal on the basis of preoperative and postoperative measurements, the authors investigated the clinical usefulness of cardiacgated phase-contrast MR imaging in patients with CM-I. Methods Ninety patients with CM-I underwent preoperative MR imaging of CSF pulsation. Syringomyelia was present in 59 patients and absent in 31 patients. Phase-contrast MR imaging of the entire CNS was used to investigate 22 patients with CM-I before surgery and after a mean postoperative period of 12 months (median 12 months, range 3–33 months). In addition to the dynamic studies, absolute flow velocities, the extension of the syrinx, and tonsillar descent were also measured. Results The changes in pulsation were highly significant in the region of the (enlarged) cistern (p = 0.0005). Maximum and minimum velocities (the pulsation amplitude) increased considerably in the region where the syrinx was largest in diameter. The changes of pulsation in these patients were significant in the subarachnoid space in all spinal segments but not in the syrinx itself and in the central canal. Conclusions The demonstration of CSF flow pulsation can contribute to assessments of surgical outcomes. The results presented here, however, raise doubts about current theories on the pathogenesis of syringomyelia.

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