CARDIAC-GATED PHASE-CONTRAST MAGNETIC RESONANCE IMAGING OF CEREBROSPINAL FLUID FLOW IN THE DIAGNOSIS OF IDIOPATHIC SYRINGOMYELIA

Neurosurgery ◽  
2008 ◽  
Vol 63 (6) ◽  
pp. 1139-1144 ◽  
Author(s):  
Uwe Max Mauer ◽  
Gregor Freude ◽  
Burkhardt Danz ◽  
Ulrich Kunz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Phase Contrast ◽  
Spinal Injury ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Cerebrospinal Fluid Flow ◽  
Flow Blockage ◽  
Idiopathic Syringomyelia

Abstract OBJECTIVE Syringomyelia without an obvious cause, such as a Chiari malformation, a tumor, or a spinal injury, is rare and may be associated with an arachnoid web or cyst. In the literature, conventional myelography is the diagnostic method of choice. In this retrospective study, we evaluated the diagnostic value of magnetic resonance imaging (MRI) cerebrospinal fluid (CSF) flow studies as compared with conventional myelography in patients with syringomyelia. METHODS From early 2003 to late 2006, 320 patients with syringomyelia underwent cardiac-gated phase-contrast MRI of CSF flow in the brain and spine. We assessed the presence of CSF flow blockage as well as syrinx site, shape, and size. Additional myelography was performed in 8 patients. CSF flow blockage and progressive neurological symptoms or progression of syringomyelia were indications for surgery. RESULTS Syringomyelia without an obvious cause was found in 125 patients. CSF flow blockage was detected in 33 patients. Seven of these patients underwent cyst wall resection and decompression of the subarachnoid space via a unilateral approach without laminectomy. Myelography revealed CSF flow blockage in only 2 of 8 cases. In the other 6 patients, MRI detected a blockage and surgery revealed arachnoid cysts or webs. Postoperative CSF flow studies revealed free CSF flow in all 10 surgically treated patients. In 6 of these patients, syrinx size was reduced after surgery. CONCLUSION Myelography should not be the method of choice for the diagnosis of idiopathic syringomyelia. MRI CSF flow studies were found to be more reliable.

scholarly journals Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

2021 ◽  
Author(s):  
Pankaj Arora ◽  
Kanica Rawat ◽  
Rajiv Azad ◽  
Kehkashan Chouhan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Phase Contrast ◽  
Flow Dynamics ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Group I ◽  
Group Ii

Abstract Objective Aim of this study is to evaluate the effect of craniospinal interventions on cerebrospinal fluid (CSF) flow hydrodynamics and study the correlation of postoperative changes in flow alteration with clinical outcome. Materials and Methods Fifty patients who underwent various craniospinal procedures were studied using conventional and phase-contrast magnetic resonance imaging (PCMRI) protocol. CSF flow quantification was performed at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels with site showing maximal alteration of CSF flow dynamics considered as the region of interest. Velocity encoding was kept at 20 cm/s. Patients with pathology atcraniovertebral junction were considered separately (group I) from others (group II) due to different flow dynamics. Follow-up scans were performed after an interval of 1 month for temporal evaluation of changes in CSF flow dynamics. Results Patients in both groups showed a significant change in peak CSF velocity postoperatively (mean change of 1.34 cm/s in group I and 0.28 cm/s in group II) with bidirectional improvement in flow on cine-phase-contrast qualitative images. Regional pain (82%) and headache (46%) were seen in most of the patients preoperatively. Postoperatively clinical symptoms improved in 59.5%, static in 26.2%, and worsened in 14.3%. In both the groups, an improvement in clinical symptomatology had significant correlation with mean changes in peak CSF velocity postoperatively (p = 0.04 in both groups). Conclusion PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively. This may have potential role in determining clinical outcome and prognosis of patients undergoing procedures in craniospinal axis.

scholarly journals Dynamic magnetic resonance imaging of the cerebrospinal fluid flow within the cerebral aqueduct by different FISIP 2D sequences

2010 ◽  
Vol 67 (5) ◽  
pp. 357-363
Author(s):  
Milos Lucic ◽  
Katarina Koprivsek ◽  
Viktor Till ◽  
Zoran Vesic
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Magnetic Resonance ◽  
Cine Mri ◽  
Cerebral Aqueduct ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Cerebrospinal Fluid Flow ◽  
Technical Parameters

Background/Aim. A vast majority of current radiogical techniques, such as computerized tomography (CT) and magnetic resonance imaging (MRI) have great potential of visualization and delineation of cerebrospinal fluid spaces morphology within cerebral aqueduct. The aim of this study was to determine the possibilities of two differently acquired FISP (Fast Imaging with Steady State Precession) 2D MR sequences in the estimation of the pulsatile cerebrospinal fluid (CSF) flow intensity through the normal cerebral aqueduct. Methods. Sixty eight volunteers underwent brain MRI on 1.5T MR imager with additionally performed ECG retrospectively gated FISP 2D sequences (first one, as the part of the standard software package, with following technical parameters: TR 40, TE 12, FA 17, Matrix: 192 ? 256, Acq 1, and the second one, experimentally developed by our investigation team: TR 30, TE 12, FA 70, Matrix: 192 ? 256, Acq 1) respectively at two fixed slice positions - midsagittal and perpendicular to cerebral aqueduct, displayed and evaluated by multiplegated images in a closed-loop cinematographic (CINE) format. Results. Normal brain morphology with preserved patency of the cerebral aqueduct in all of 68 healthy volunteers was demonstrated on MRI examination. Cerebrospinal fluid flow within the cerebral aqueduct was distinguishable on both CINE MRI studies in midsagittal plane, but the estimation of intraaqueductal CSF flow in perpendicular plane was possible on CINE MRI studies acquired with experimentally improved FISP 2D (TR 30, FA 70) sequence only. Conclusion. Due to the changes of technical parameters CINE MRI study acquired with FISP 2D (TR 30, FA 70) in perpendicular plane demonstrated significantly higher capability in the estimation of the CSF pulsation intensity within the cerebral aqueduct. .

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