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Visualization of cerebrospinal fluid flow in syringomyelia through noninvasive magnetic resonance imaging with a
Kazuhiro Takeuchi1, Atsushi Ono2, Yusuke Hashiguchi2
1a Department of Orthopedic Surgery , National Hospital Organization Okayama Medical Center , Okayama , Japan.
Context:
We report a case of syringomyelia assessed by magnetic resonance imaging (MRI) with a time-spatial labeling inversion pulse (Time-SLIP), which is a non-contrast MRI technique that uses the cerebrospinal fluid (CSF) as an intrinsic tracer, thus removing the need to administer a contrast agent. Time-SLIP permits investigation of flow movement for over 3 seconds without any limitations associated with the cardiac phase, and it is a clinically accessible method for flow analysis.
Findings:
We investigated an 85-year-old male experiencing progressive gait disturbance, with leg numbness and muscle weakness. Conventional MRI revealed syringomyelia from C7 to T12, with multiple webs of cavities. We then applied the Time-SLIP approach to characterize CSF flow in the syringomyelic cavities. Time-SLIP detected several unique CSF flow patterns that could not be observed by conventional imaging. The basic CSF flow pattern in the subarachnoid space was pulsatile and was harmonious with the heartbeat. Several unique flow patterns, such as bubbles, jumping, and fast flow, were observed within syringomyelic cavities by Time-SLIP imaging. These patterns likely reflect the complex flow paths through the septum and/or webs of cavities.
Conclusion/Clinical Relevance:
Time-SLIP permits observation of CSF motion over a long period of time and detects patterns of flow velocity and direction. Thus, this novel approach to CSF flow analysis can be used to gain a more extensive understanding of spinal disease pathology and to optimize surgical access in the treatment of spinal lesions. Additionally, Time-SLIP has broad applicability in the field of spinal research.
Insights
Time-spatial labeling inversion pulse (Time-SLIP) MRI reveals unique cerebrospinal fluid (CSF) flow patterns in syringomyelia, aiding in understanding spinal disease and surgical planning.
Area of Science:
- Neurology
- Radiology
- Biomedical Engineering
Background:
- Syringomyelia involves spinal cord cavities, often assessed with conventional MRI.
- Cerebrospinal fluid (CSF) dynamics are crucial for understanding spinal pathologies.
Observation:
- A case of syringomyelia was evaluated using time-spatial labeling inversion pulse (Time-SLIP) MRI.
- This non-contrast technique utilizes CSF as an intrinsic tracer.
- Time-SLIP allows for extended observation of CSF flow, independent of cardiac phase.
Findings:
- Conventional MRI showed syringomyelia with cavities from C7 to T12.
- Time-SLIP imaging detected unique CSF flow patterns within the cavities, including pulsatile, bubble-like, jumping, and fast flow.
- These patterns suggest complex flow dynamics through syringomyelic septa and webs.
Implications:
- Time-SLIP provides a detailed analysis of CSF motion, velocity, and direction.
- This technique enhances understanding of spinal disease pathology.
- It offers potential for optimizing surgical access and treatment planning for spinal lesions.
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