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Related Experiment Videos

Dynamic physiologic changes in lumbar CSF volume quantitatively measured by three-dimensional fast spin-echo MRI.

R R Lee1, R A Abraham, C B Quinn

  • 1Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA. rrlee@unm.edu

Spine
|June 20, 2001
PubMed
Summary

This study validates MRI to measure spinal cerebrospinal fluid (CSF) volume. Physiologic maneuvers cause reversible CSF volume changes, primarily due to epidural venous plexus engorgement.

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Area of Science:

  • Neuroimaging
  • Anatomy
  • Physiology

Background:

  • Previous studies qualitatively showed spinal cerebrospinal fluid (CSF) volume changes with maneuvers but lacked visualization of the underlying anatomy.
  • Older techniques like radiography and radionuclide myelography had limitations in visualizing the thecal sac and CSF dynamics.

Purpose of the Study:

  • To validate a magnetic resonance imaging (MRI) technique for quantifying lumbar CSF volume.
  • To measure resting lumbar CSF volume in adults.
  • To assess changes in CSF volume during physiologic maneuvers and identify the anatomical basis for these changes.

Main Methods:

  • Lumbar MRI was performed on four adult volunteers using a fat-saturated T2-weighted 3D fast spin-echo sequence.
  • Quantitative image analysis measured lumbar CSF volume at rest and during hyperventilation, abdominal compression, and combined maneuvers.

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  • The MRI technique was validated using a water phantom.

    • Main Results:

    • Resting lumbar CSF volume ranged from 28 to 42 mL.
    • Physiologic maneuvers caused reversible changes in lumbar CSF volume: 10% reduction with hyperventilation, 28% with compression, and 41% with combined maneuvers.
    • These volume changes were visualized to be caused by engorgement of the epidural venous plexus, which compressed the thecal sac.

    Conclusions:

    • MRI offers a noninvasive method for measuring spinal CSF volume.
    • The study demonstrated the anatomical basis for CSF volume fluctuations during physiologic maneuvers.
    • Findings have significant implications for understanding spinal anesthesia.