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In Vivo Imaging of Cerebrospinal Fluid Transport through the Intact Mouse Skull using Fluorescence Macroscopy

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Flow Imaging in Normal Pressure Hydrocephalus.

Petrice M Cogswell¹, Pragalv Karki², Daehun Kang²

¹From the Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA and Department of Medical Physics, Mayo Clinic, Rochester, Minnesota, USA. Cogswell.petrice@mayo.edu.

AJNR. American Journal of Neuroradiology

|April 13, 2026

Summary

This summary is machine-generated.

Flow imaging of the cerebral aqueduct aids in diagnosing normal pressure hydrocephalus (NPH) and its subtypes. Advanced techniques like 4D flow imaging offer comprehensive insights into cerebrospinal fluid (CSF) dynamics.

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Area of Science:

Neurology
Medical Imaging
Fluid Dynamics

Background:

Cerebral aqueduct flow imaging is used to diagnose normal pressure hydrocephalus (NPH) and its subtypes.
Two-dimensional phase contrast MRI assesses pulsatile flow but has limitations in sensitivity and correlation with outcomes.
Aqueduct imaging aids in differentiating congenital from idiopathic NPH (iNPH).

Purpose of the Study:

To evaluate imaging features supporting NPH diagnosis.
To determine NPH subtypes.
To explore advanced flow imaging techniques for better intracranial CSF dynamics assessment.

Main Methods:

Utilized two-dimensional cardiac gated phase contrast MRI for aqueduct flow measurement.
Incorporated real-time imaging to assess cardiac and respiratory flow contributions.
Employed 4D flow imaging for volumetric assessment of intracranial CSF dynamics.

Main Results:

Standard aqueduct flow measurements show limited sensitivity for NPH diagnosis and poor correlation with clinical outcomes.
Advanced techniques like real-time and 4D flow imaging provide more comprehensive intracranial CSF dynamic assessments.
Structural and flow imaging assist in differentiating NPH subtypes, guiding patient management.

Conclusions:

Cerebral aqueduct flow imaging is valuable for NPH diagnosis and subtype differentiation.
Limitations exist with traditional 2D phase contrast MRI methods.
Emerging real-time and 4D flow imaging techniques enhance the comprehensive assessment of CSF dynamics in NPH.