Analysis of cerebrospinal fluid flow waveforms with gated phase-contrast MR velocity measurements

To analyze the characteristics of normal cerebrospinal fluid (CSF) flow waveforms and to relate them to the arterial input and venous output flow waveforms in healthy volunteers.

Cine phase-contrast MR was obtained in 17 volunteers. The temporal velocity information from the cervical pericord CSF spaces, basal cisterns, and aqueduct, as well as the internal carotid and vertebral arteries and internal jugular veins, were plotted as waveforms. The waveforms were analyzed for configurations, amplitudes, and temporal patterns. In four volunteers the reproducibility of the precord CSF flow waveforms was examined on different days. In three volunteers the effect of jugular venous compression on the precord and aqueductal CSF flow waveforms was also evaluated.

(a) Distinct and reproducible configurational features were observed in the CSF flow waveforms. Jugular venous compression produced elevation of the disatolic slope of the precord waveforms. (b) The amplitudes were variable. Jugular venous compression reduced the precord CSF velocities. (c) The systolic temporal parameters were less variable and more reproducible than the diastolic temporal parameters. Jugular venous compression resulted in delay in the systolic parameters of the precord waveforms. (d) Craniocaudal and caudocranial postcord CSF flow occurred either simultaneous with or earlier than the precord CSF flow. Pericord CSF flow in either direction preceded that in the cisterns and in the aqueduct. (e) A significant temporal relationship was noted in the precord space between the time of the R wave to the maximum velocities and the arterial flow.

CSF flow waveform analysis seems to be a reliable, reproducible, and sensitive method for assessing the CSF dynamics.