Cine MR CSF flow study in hydrocephalus: what are the valuable parameters?

Area of Science:

• Neurosurgery
• Radiology
• Medical Imaging

Background:

• Hydrocephalus involves abnormal accumulation of cerebrospinal fluid (CSF) within the brain's ventricles.
• Understanding CSF dynamics is crucial for diagnosing and managing hydrocephalus.
• Cine phase contrast (PC) magnetic resonance (MR) imaging offers a non-invasive method to assess CSF flow.

Purpose of the Study:

• To evaluate alterations in intracranial CSF dynamics in hydrocephalus using cine PC MR imaging.
• To compare CSF flow parameters between hydrocephalus patients and healthy controls.
• To determine if MR imaging can identify obstruction sites in hydrocephalus.

Main Methods:

• 1.5 T cine PC MR imaging with cardiac gating was used in 10 non-obstructive hydrocephalus (NOH), 3 obstructive hydrocephalus (OH), and 10 control subjects.
• Temporal velocity waveforms were analyzed for configuration, amplitude (Smax, Smin, Sdif), and temporal parameters (R-S, R-SMV, R-D, R-DMV) in specific regions of interest.
• Statistical significance was assessed using paired t-tests.

Main Results:

• Distinct reproducible waveform configurations were observed in aqueductal and cervical pericord spaces.
• Statistically significant differences between controls and hydrocephalus were found primarily in temporal parameters.
• Shortening of R-DMV (p < 0.01) in NOH and R-DMV (p < 0.05) and R-SMV (p < 0.02) in OH at cervical pericord spaces were noted.
• The level of obstruction was identifiable in all OH cases.

Conclusions:

• Cine PC MR imaging provides valuable insights into CSF flow dynamics in hydrocephalus.
• Analysis of temporal parameters can help pinpoint obstruction sites, aiding in hydrocephalus diagnosis.
• This imaging technique can inform decisions regarding the necessity of shunting procedures.