Cine Phase-Contrast MRI
Cine Phase-Contrast MRI
Object. The purpose of this prospective study was to evaluate aqueductal cerebrospinal fluid (CSF) flow after endoscopic aqueductoplasty. In all patients, preoperative magnetic resonance (MR) imaging revealed hydrocephalus caused by aqueductal stenosis and lack of aqueductal CSF flow.
Methods. In 14 healthy volunteers and in eight patients with aqueductal stenosis who had undergone endoscopic aqueductoplasty, aqueductal CSF flow was investigated using cine cardiac-gated phase-contrast MR imaging. For qualitative evaluation of CSF flow, the authors used an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Quantitative through-plane measurements were performed in the axial plane perpendicular to the aqueduct. Evaluation revealed no significant difference in aqueductal CSF flow between healthy volunteers and patients with regard to temporal parameters, CSF peak and mean velocities, mean flow, and stroke volume. All restored aqueducts have remained patent 7 to 31 months after surgery.
Conclusions. Aqueductal CSF flow after endoscopic aqueductoplasty is similar to aqueductal CSF flow in healthy volunteers. The data indicate that endoscopic aqueductoplasty seems to restore physiological aqueductal CSF flow.
Cine phase-contrast MR imaging has been increasingly used during the last decade for evaluating cranial and spinal CSF flow. The phase-contrast technique is extremely sensitive, even to slow flow, and provides the potential for noninvasive flow quantification. The results of these measurements have yielded considerable information on the physiology of the normal CSF circulation. In addition, pathological CSF flow dynamics in communicating and obstructive hydrocephalus, Chiari malformation, 8 cystic lesion, and cervical spondylosis have been analyzed. With the increasing frequency of neuroendoscopic procedures, cine MR imaging has been recommended for evaluating the patency of third ventriculostomies. Aqueductal CSF flow after endoscopic aqueductoplasty, however, has not yet been investigated. We performed a prospective study to compare the aqueductal CSF flow in healthy volunteers and patients who had undergone endoscopic restoration of aqueductal patency.
Abstract
Object. The purpose of this prospective study was to evaluate aqueductal cerebrospinal fluid (CSF) flow after endoscopic aqueductoplasty. In all patients, preoperative magnetic resonance (MR) imaging revealed hydrocephalus caused by aqueductal stenosis and lack of aqueductal CSF flow.
Methods. In 14 healthy volunteers and in eight patients with aqueductal stenosis who had undergone endoscopic aqueductoplasty, aqueductal CSF flow was investigated using cine cardiac-gated phase-contrast MR imaging. For qualitative evaluation of CSF flow, the authors used an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Quantitative through-plane measurements were performed in the axial plane perpendicular to the aqueduct. Evaluation revealed no significant difference in aqueductal CSF flow between healthy volunteers and patients with regard to temporal parameters, CSF peak and mean velocities, mean flow, and stroke volume. All restored aqueducts have remained patent 7 to 31 months after surgery.
Conclusions. Aqueductal CSF flow after endoscopic aqueductoplasty is similar to aqueductal CSF flow in healthy volunteers. The data indicate that endoscopic aqueductoplasty seems to restore physiological aqueductal CSF flow.
Introduction
Cine phase-contrast MR imaging has been increasingly used during the last decade for evaluating cranial and spinal CSF flow. The phase-contrast technique is extremely sensitive, even to slow flow, and provides the potential for noninvasive flow quantification. The results of these measurements have yielded considerable information on the physiology of the normal CSF circulation. In addition, pathological CSF flow dynamics in communicating and obstructive hydrocephalus, Chiari malformation, 8 cystic lesion, and cervical spondylosis have been analyzed. With the increasing frequency of neuroendoscopic procedures, cine MR imaging has been recommended for evaluating the patency of third ventriculostomies. Aqueductal CSF flow after endoscopic aqueductoplasty, however, has not yet been investigated. We performed a prospective study to compare the aqueductal CSF flow in healthy volunteers and patients who had undergone endoscopic restoration of aqueductal patency.
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