Evaluation of cerebrospinal fluid flow dynamic changes in patients with idiopathic intracranial hypertension using phase contrast cine MR imaging

Abstract Background Idiopathic intracranial hypertension (IIH) mainly affects overweight women in the middle age period. The pathophysiology of IIH stays unclear, but suggested mechanisms include excess CSF production, reduced CSF absorption, increased brain water content, and increased cerebral venous pressure Objectives To assess the cerebrospinal fluid (CSF) flow dynamic changes in aqueduct of Sylvius in patients of idiopathic intracranial hypertension (IIH) with new MRI technique: phase contrast cine MRI (PCC-MRI). Methods Thirty patients diagnosed with idiopathic intracranial hypertension were divided into 3 groups according to treatment options (no treatment, medical treatment, and medical treatment with repeated lumbar tapping). CSF flow data were evaluated by phase contrast cine MRI. Results PCC-MRI parameters were significantly higher in group who was on medical treatment (group II) than other groups. The sensitivity of PCC MRI parameters ranged from 56.7 (stroke volume (SV) and mean flow (MF)) to 83.3% (peak systolic velocity (PSV)). A statistically significant difference was found for the mean flow value (p 0.039) between the control group and IIH patients. Conclusion The most specific CSF flowmetry parameter detected to help diagnosis of IIH is mean flow especially among early discovered patients. PCC MRI can be used as non-invasive technique for diagnosis of IIH and treatment follow-up.

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Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging

Neurosurgical FOCUS ◽

10.3171/foc.2000.9.2.7 ◽

2000 ◽

Vol 9 (2) ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Henry W. S. Schroeder ◽

Christiane Schweim ◽

Klaus H. Schweim ◽

Michael R. Gaab

Keyword(s):

Cerebrospinal Fluid ◽

Magnetic Resonance ◽

Mr Imaging ◽

Healthy Volunteers ◽

Phase Contrast ◽

Aqueductal Stenosis ◽

Mean Flow ◽

Csf Flow ◽

Significant Difference ◽

Endoscopic Aqueductoplasty

Object The purpose of this prospective study was to evaluate aqueductal cerebrospinal fluid (CSF) flow after endoscopic aqueductoplasty. In all patients, preoperative magnetic resonance (MR) imaging revealed hydrocephalus caused by aqueductal stenosis and lack of aqueductal CSF flow. Methods In 14 healthy volunteers and in eight patients with aqueductal stenosis who had undergone endoscopic aqueductoplasty, aqueductal CSF flow was investigated using cine cardiac-gated phase-contrast MR imaging. For qualitative evaluation of CSF flow, the authors used an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Quantitative through-plane measurements were performed in the axial plane perpendicular to the aqueduct. Evaluation revealed no significant difference in aqueductal CSF flow between healthy volunteers and patients with regard to temporal parameters, CSF peak and mean velocities, mean flow, and stroke volume. All restored aqueducts have remained patent 7 to 31 months after surgery. Conclusions Aqueductal CSF flow after endoscopic aqueductoplasty is similar to aqueductal CSF flow in healthy volunteers. The data indicate that endoscopic aqueductoplasty seems to restore physiological aqueductal CSF flow.

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Quantitative analysis of cerebrospinal fluid dynamics at phase contrast cine-MRI: predictivity of neurosurgical "Shunt" responsiveness in patients with idiopathic normal pressure hydrocephalus

Journal of Neurosurgical Sciences ◽

10.23736/s0390-5616.17.04092-9 ◽

2020 ◽

Vol 64 (5) ◽

Author(s):

Alessandro Stecco ◽

Alessia Cassarà ◽

Alberto Zuccalà ◽

Mihaela B. Anoaica ◽

Egidio Genovese ◽

...

Keyword(s):

Fluid Dynamics ◽

Cerebrospinal Fluid ◽

Quantitative Analysis ◽

Normal Pressure Hydrocephalus ◽

Phase Contrast ◽

Normal Pressure ◽

Idiopathic Normal Pressure Hydrocephalus ◽

Cine Mri ◽

Cerebrospinal Fluid Dynamics

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

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734362 ◽

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.

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Characteristics of the cerebrospinal fluid pressure waveform and craniospinal compliance in idiopathic intracranial hypertension subjects

Fluids and Barriers of the CNS ◽

10.1186/s12987-018-0106-5 ◽

2018 ◽

Vol 15 (1) ◽

Cited By ~ 3

Author(s):

Monica D. Okon ◽

Cynthia J. Roberts ◽

Ashraf M. Mahmoud ◽

Andrew N. Springer ◽

Robert H. Small ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Intracranial Hypertension ◽

Idiopathic Intracranial Hypertension ◽

Fluid Pressure ◽

Cerebrospinal Fluid Pressure ◽

Pressure Waveform

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Evaluation of CSF flow metrics in patients with communicating hydrocephalus and idiopathic intracranial hypertension

La radiologia medica ◽

10.1007/s11547-018-0979-z ◽

2018 ◽

Vol 124 (5) ◽

pp. 382-391 ◽

Cited By ~ 3

Author(s):

Temel Fatih Yılmaz ◽

Ayse Aralasmak ◽

Huseyin Toprak ◽

Elnur Mehdi ◽

Gulsen Kocaman ◽

...

Keyword(s):

Intracranial Hypertension ◽

Idiopathic Intracranial Hypertension ◽

Communicating Hydrocephalus ◽

Csf Flow

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Associations between blood and cerebrospinal fluid flow impairments assessed with phase-contrast MRI and brain damage in patients with age-related cerebral small vessel disease

Bulletin of Russian State Medical University ◽

10.24075/brsmu.2019.054 ◽

2019 ◽

pp. 16-23

Author(s):

E.I. Kremneva ◽

B.M. Akhmetzyanov ◽

L.A. Dobrynina ◽

M.V. Krotenkova

Keyword(s):

Cerebrospinal Fluid ◽

Brain Damage ◽

Phase Contrast ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Csf Flow ◽

Phase Contrast Mri ◽

Vessel Disease ◽

Age Related

Hemodynamic parameters of blood and cerebrospinal fluid (CSF) flow can be measured in vivo using phase-contrast MRI (PC-MRI). This opens new horizons for studying the mechanisms implicated in the development and progression of age-related cerebral small vessel disease (SVD). In this paper, we analyze associations between cerebral arterial, venous and CSF flow impairments and SVD features visible on MRI. The study was carried out in 96 patients with SVD (aged 60.91 ± 6.57 years) and 23 healthy volunteers (59.13 ± 6.56 years). The protocol of the MRI examination included routine MRI sequences (T2, FLAIR, T1, SWI, and DWI) applied to assess the severity of brain damage according to STRIVE advisory standards and PC-MRI used to quantify blood flow in the major arteries and veins of the neck, the straight and upper sagittal sinuses, and CSF flow at the aqueduct level. We analyzed the associations between linear and volumetric parameters of blood/CSF flow and the degree of brain matter damage using the Fazekas scale. We observed a reduction in tABF, stVBF, sssVBF, aqLF, Saq, and ICC values and a rise in Pi associated with WMH progression, as well as a gradual decline in tABF and an increase in Pi, Saq and ICC associated with a growing number of lacunes (р < 0.05). Patients with early (< 5) MB had lower sssVBF and stVBF rates in comparison with patients without MB; aqLF, Saq, and ICC values were elevated in patients with 5 to 10 MB, as compared to patients without MB or early (< 5) MB. The established associations between MRI findings in patients with SVD and blood/CSF flow impairments suggest the important role of mechanisms implicated in the disruption of Monro–Kellie intracranial homeostasis in promoting SVD.

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