Article
Normal cerebrospinal fluid pulsations in the region of the spine on phase-contrast magnetic resonance images
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Published: | May 20, 2009 |
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Objective: Numerous theories have attempted to explain the location and velocity of cerebrospinal fluid (CSF) pulsations in the spinal canal. Cardiac-gated magnetic resonance imaging (MRI) can provide evidence that may prove or disprove these theories.
Methods: Seventeen patients (5 women, 12 men; mean age: 51 years, median age: 51 years, range: 15-76 years) who presented with unclear symptoms but no evidence of CSF flow obstruction or hydrocephalus underwent MRI, which was mainly ordered to investigate the presence or absence of morphological changes, as well as phase-contrast MRI, which allowed us to study CSF flow.
Results: In the region of the cervical spine, CSF flow pulsations were mainly located in the ventral subarachnoid space. They shifted dorsally at the cervicothoracic junction. In the region of the thoracic spine, CSF flow pulsations were mainly located in the dorsal subarachnoid space. Pulsations of a similar magnitude were seen dorsal and ventral to the conus medullaris and diminished in the caudal direction. There were no differences between systole and diastole. Median velocities of 1 to 2 cm/s were measured in the region of the spinal subarachnoid space. Similarly, median flow velocities of about 1 cm/s were measured at the craniocervical junction. There was marked interindividual variability.
Conclusions: CSF flow pulsations of varying magnitudes are found in the various areas of the spine. Our results do not support existing theories of CSF flow patterns.