Evaluation of CSF flow in shunts using a non-invasive thermal technique

Imaging techniques may be underutilised when clinicians are unaware of the technique or do not recognise its potential. Phase-contrast MR imaging (PC-MRI) is a rapid, simple and non-invasive technique that is sensitive to CSF flow. It demonstrates a mechanical coupling between cerebral blood and CSF flow throughout the cardiac cycle. Neurosurgeons should be able to request this procedure routinely as part of an MRI request. This paper gives an overview of the indications, technical requirements, technique and interpretation, using image examples. Indications for CSF flow studies include assessment and functionality of shunt treatment in patients with hydrocephalus; hydrocephalus associated with achondroplasia; Chiari I malformation; confirmation of aqueductal stenosis; and determining patency of a third ventriculostomy.

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Investigation of cerebrospinal fluid flow in the cerebral aqueduct using high-resolution phase contrast measurements at 7T MRI

Acta Radiologica ◽

10.1177/0284185117740762 ◽

2017 ◽

Vol 59 (8) ◽

pp. 988-996 ◽

Cited By ~ 6

Author(s):

Karin Markenroth Bloch ◽

Johannes Töger ◽

Freddy Ståhlberg

Keyword(s):

Cerebrospinal Fluid ◽

High Resolution ◽

Spatial Resolution ◽

Maximum Velocity ◽

Cerebral Aqueduct ◽

Mean Flow ◽

Csf Flow ◽

Flow Measurements ◽

Non Invasive ◽

Wide Range

Background The cerebral aqueduct is a central conduit for cerebrospinal fluid (CSF), and non-invasive quantification of CSF flow in the aqueduct may be an important tool for diagnosis and follow-up of treatment. Magnetic resonance (MR) methods at clinical field strengths are limited by low spatial resolution. Purpose To investigate the feasibility of high-resolution through-plane MR flow measurements (2D-PC) in the cerebral aqueduct at high field strength (7T). Material and Methods 2D-PC measurements in the aqueduct were performed in nine healthy individuals at 7T. Measurement accuracy was determined using a phantom. Aqueduct area, mean velocity, maximum velocity, minimum velocity, net flow, and mean flow were determined using in-plane resolutions 0.8 × 0.8, 0.5 × 0.5, 0.3 × 0.3, and 0.2 × 0.2 mm2. Feasibility criteria were defined based on scan time and spatial and temporal resolution. Results Phantom validation of 2D-PC MR showed good accuracy. In vivo, stroke volume was −8.2 ± 4.4, −4.7 ± 2.8, −6.0 ± 3.8, and −3.7 ± 2.1 µL for 0.8 × 0.8, 0.5 × 0.5, 0.3 × 0.3, and 0.2 × 0.2 mm2, respectively. The scan with 0.3 × 0.3 mm2 resolution fulfilled the feasibility criteria for a wide range of heart rates and aqueduct diameters. Conclusion 7T MR enables non-invasive quantification of CSF flow and velocity in the cerebral aqueduct with high spatial resolution.

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MRI CSF flowmetry in evaluation of different neurological diseases

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00429-w ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Nermin Ahmad ◽

Dina Salama ◽

Mohammad Al-Haggar

Keyword(s):

Neurological Diseases ◽

Therapeutic Option ◽

Peak Systolic Velocity ◽

Maximum Velocity ◽

Invasive Technique ◽

Control Group ◽

Type I ◽

Csf Flow ◽

Non Invasive ◽

Diastolic Velocity

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.

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Non-Invasive Quantification of CSF Flow in Shunts

Intracranial Pressure VIII ◽

10.1007/978-3-642-77789-9_198 ◽

1993 ◽

pp. 909-912

Author(s):

J. Ryder ◽

R. A. Zappulla ◽

C. Drost ◽

A. Draudt ◽

A. M. Aron

Keyword(s):

Csf Flow ◽

Non Invasive

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Clinical Validity of the MoSeSS RARE-Sequence at CSF Flow Disturbances

Rivista di Neuroradiologia ◽

10.1177/197140090201500603 ◽

2002 ◽

Vol 15 (6) ◽

pp. 661-678

Author(s):

M. Orszagh ◽

M. Büchert ◽

D. M. Schulte ◽

J. K. Krauss ◽

M. Schumacher ◽

...

Keyword(s):

Real Time ◽

Third Ventricle ◽

Clinical Information ◽

Diagnostic Methods ◽

Single Shot ◽

Clinical Validity ◽

Csf Flow ◽

Non Invasive ◽

Flow Disturbances ◽

Rare Sequence

The development of non-invasive diagnostic methods is a matter of great importance. This paper describes Motion Sensitized Single Shot RARE Sequences (MoSeSS) as a new, non-invasive diagnostic method in CSF-flow disturbances. The range of applications and clinical validity are examined. The strongly T2-weighted RARE-sequence displays selectively unbound water. The addition of flowencoding gradients shows moving spins flow-dependently as a signal reduction. ECG-triggering enablesthe registration of present flow phases, and the CSF-flow can be observed as cine-mode in quasi real-time. Thirty healthy subjects and 137 patients from subcollectives with diverse CSF-flow disturbances were investigated. The MoSeSS RARE-sequence provides reliable information in occlusion or stenoses of the inner CSF-spaces and in ventriculocisternostomies. Indirect signs of shunt dysfunction are CSF turbulences which correlate in degree with the increase in CSF pressure. Determination of localization and degree of dural impairment in traumatic or postoperative pseudomeningoceles is dependent on the activity of the CSF-flow at the leak. Depending on the stage of NPH, a variably marked active flow oscillation in the aqueduct and in the third ventricle is shown. Liquorrhoea has no definable flow detectable with the MoSeSS RARE-sequence. Vascular pulsation can make differentiation of the CSF-flow from artefacts difficult near larger vessels. The MoSeSS-RARE-Sequence is a fast, non-invasive and radiation-free method, which yields valid clinical information on circulation disturbances in the inner CSF-spaces. With the cine-mode technique, CSF movements can be observed in quasi real-time. Positive enhancement of the CSF is necessary in assessing processes with an undefined, non-detectable flow.

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Phase-Contrast-Cine MRI: a non-invasive qualitative approach to the study of various diseases of the Central Nervous System

Journal of Advanced Health Care ◽

10.36017/jahc1912-001 ◽

2019 ◽

Author(s):

Calligari Dalila ◽

Corvaglia Martina ◽

Stringile Michela ◽

Colombo Giovanni ◽

Assirelli Angela

Keyword(s):

Phase Contrast ◽

Sagittal Plane ◽

Anatomical Study ◽

Cine Mri ◽

Csf Flow ◽

Non Invasive ◽

Contrast Technique ◽

Invasive Method ◽

The Central Nervous System ◽

Phase Phase

The introduction of velocity-sensitive sequences, such as those based on the phase-contrast technique, has recently established a lure for the evaluation of the dynamics of CSF in MRI because it is the only non-invasive method for the study of the CSF flow. These sequences add to the classic anatomical study of brain, a qualitative functional analysis of his cerebrospinal fluid system studied with sequences acquired in the sagittal plane, maintaining high spatial and temporal resolution despite the small size of the analyzed section and the low speed of the circulating liquor. The aim of this paper is to illustrate the importance of using amplitude and phase (Phase Contrast) images in Cine-RM, in healthy subjects and in patients with intra-cranial and cervical district diseases.

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X-ray microtomography

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100107058 ◽

1988 ◽

Vol 46 ◽

pp. 998-999

Author(s):

H.W. Deckman ◽

B.F. Flannery ◽

J.H. Dunsmuir ◽

K.D' Amico

Keyword(s):

Computed Tomography ◽

Internal Structure ◽

Imaging Technique ◽

Three Dimensional ◽

Tissue Structure ◽

Individual Element ◽

X Ray ◽

Non Invasive ◽

Panoramic Imaging ◽

Three Dimensional Images

We have developed a new X-ray microscope which produces complete three dimensional images of samples. The microscope operates by performing X-ray tomography with unprecedented resolution. Tomography is a non-invasive imaging technique that creates maps of the internal structure of samples from measurement of the attenuation of penetrating radiation. As conventionally practiced in medical Computed Tomography (CT), radiologists produce maps of bone and tissue structure in several planar sections that reveal features with 1mm resolution and 1% contrast. Microtomography extends the capability of CT in several ways. First, the resolution which approaches one micron, is one thousand times higher than that of the medical CT. Second, our approach acquires and analyses the data in a panoramic imaging format that directly produces three-dimensional maps in a series of contiguous stacked planes. Typical maps available today consist of three hundred planar sections each containing 512x512 pixels. Finally, and perhaps of most import scientifically, microtomography using a synchrotron X-ray source, allows us to generate maps of individual element.

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