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MR of slow CSF flow in the spine
D Schellinger1, D LeBihan, S S Rajan
1Department of Radiology, Georgetown University Medical Center, Washington, DC 20007.
Purpose:
To evaluate a slow-flow MR sequence in normal CSF flow and in CSF flow disturbance in cases of spinal stenosis.
Method:
The method was tested for flow sensitivity and applied to 67 sites of spinal canal compromise.
Results:
Phantom studies show that flow can be depicted at a velocity of 0.5-1 mm/sec. On clinical images, stagnant CSF is black, flowing CSF is bright. Typically, in high-grade (90%-100%) stenosis, CSF above and below the site of spinal canal compromise (SCC) is black. With intermediate stenosis (50%-89%), CSF above the SCC remains white but becomes black distal to the SCC. Low-grade stenosis shows only localized flow disturbances.
Conclusion:
This easy-to-use sequence can solidify the MR diagnosis of high-grade stenosis when a distinct flow pattern is recognized. Flow patterns for intermediate and low-grade stenosis are less reliable.