gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

MR velocity mapping of cerebrospinal fluid flow in the human ventricular system – a new technique to assess normal and pathological CSF dynamics

Meeting Abstract

  • Oliver Ganslandt - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Deutschland
  • Erich Salomonowitz - MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Öserreich
  • Wilma van der Riet - European MRI Consultancy (EMRIC), Straßburg, Frankreich
  • Michael Buchfelder - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Deutschland
  • Andreas Stadlbauer - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Deutschland; MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Öserreich

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1806

DOI: 10.3205/10dgnc277, URN: urn:nbn:de:0183-10dgnc2774

Published: September 16, 2010

© 2010 Ganslandt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: We adapted time-resolved 3D MR velocity mapping for investigation of flow patterns of CSF in the human ventricular system for the first time. Our aim was to use MR velocity mapping in combination with calculation of particle path lines from velocity vector field data to introduce a method for time-resolved 3D visualization of intracranial CSF flow patterns in healthy volunteers and patients with hydrocephalus.

Methods: MR imaging data of the brain were collected from nine patients with an enlarged ventricular system and nine age-matched healthy volunteers. Six patients were suspected to have hydrocephalus internus, two patients were suspected to have normal pressure hydrocephalus, and one patient had a ventriculostomy 10 years ago because of hydrocephalus internus. Time-resolved 3D MR velocity mapping data were acquired on a 1.5 Tesla whole-body system using a 3D TFE phase-contrast (PC) sequence. Retrospective vector-ECG gating was used for covering the entire cardiac cycle. The sequence yielded 12 quantitative flow-encoded 3D data sets per cardiac cycle. The measurement parameters used were: TR/TE = 16/9 ms, SENSE = 2, turbo factor = 3, spatial resolution = 1.38×1.38×1.5 mm3. In order to enable investigation of 3D velocity vectors of CSF flow, velocity encoding was performed in A>>P, L>>R, and F>>H direction. For calculation of time-resolved 3D CSF flow patterns, MR velocity mapping data were evaluated using the GTFlow software tool. CSF flow in patients was classified as “hypermotile flow” if CSF flow showed increased dynamics and as “hypomotile flow” if CSF flow showed attenuated dynamics compared to healthy volunteers.

Results: For the six patients, who were suspected of having hydrocephalus internus, four showed hypomotile CSF flow, whereas two showed hypermotile CSF flow. For the two patients, who were suspected to have normal pressure hydrocephalus, one showed hypomotile and the other showed hypermotile CSF flow. The one patient, who had undergone a ventriculostomy 10 years ago because of hydrocephalus internus showed normal CSF flow dynamics and a path of CSF flow through the opening.

Conclusions: The preliminary findings of these feasibility studies indicated changes in CSF flow patterns in patients with enlarged ventricular systems compared to volunteers. However, correlation with more detailed clinical parameters as well as examinations on clearly defined subgroups of patients with an enlarged ventricular system is necessary to investigate the usefulness of this approach.