Diagnostic Accuracy of Phase Contrast MRI Technique in Detecting Cerebrospinal Fluid Flow

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Published Mar 29, 2025
DOI: https://doi.org/10.18103/mra.v3i3.6391

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Main Article Content

Dr. Sachin Khanduri
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. Danish Ansari
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. Kunal Dwari
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. Avani Kanojia
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. Vinima Jaiswal
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. Nida Yasrab
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. K. Prithvi Perumal
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India
Dr. Sajida Ansari
Department of Radiodiagnosis, Era’s Lucknow Medical College & Hospital, Lucknow, India

Abstract

Introduction: Cerebrospinal fluid (CSF) dynamics play a critical role in neurological conditions such as normal pressure hydrocephalus (NPH), aqueductal stenosis, and Chiari malformation and also play a crucial role in maintaining the homeostasis of the central nervous system (CNS). The use of phase-contrast magnetic resonance imaging (PC-MRI) to non-invasively quantify cerebro spinal fluid dynamics (CSF) aid in diagnosis and treating such conditions. The aim of the study is to evaluate the diagnostic accuracy of phase contrast MRI technique in detecting cerebrospinal fluid flow.


Methodology: This study was a cross-sectional study and it included 136 participants and was conducted at the Department of Radiodiagnosis, Era’s Lucknow Medical College and Hospital, Lucknow, India. All subjects under the inclusion criteria, underwent PC-MRI using a 3T MRI scanner to evaluate CSF flow dynamics, with post-processing performed on a Syngovia workstation.


Results: The majority of participants were male (55.88%), with a mean age of 46.84 years. Normal pressure Hydrocephalus (NPH) was the most prevalent condition (35.29%), followed by diffuse cerebral atrophy (23.53%). The study revealed distinct cerebro spinal fluid flow patterns across neurological conditions. Normal pressure Hydrocephalus (NPH) showed the highest peak systolic velocity (PSV) at 9.24 cm/s and a stroke volume of 65 µl. Aqueductal stenosis exhibited a lower PSV of 6.53 cm/s but a higher stroke volume of 70 µl. These findings demonstrate significant variations in CSF dynamics, emphasizing the utility of PC-MRI.


Conclusion: Phase contrast – Magnetic resonance imaging is a valuable tool for assessing cerebro-spinal fluid flow dynamics, providing critical insights into the pathophysiology of neurological conditions. The study highlights the importance of peak velocity as a reliable metric, suggesting its incorporation into routine clinical assessments to enhance diagnostic accuracy and patient outcomes.

Keywords: Cerebrospinal fluid, Phase-contrast MRI, Normal pressure hydrocephalus, Chiari malformation, Aqueductal stenosis, Peak systolic velocity

Article Details

How to Cite
KHANDURI, Dr. Sachin et al. Diagnostic Accuracy of Phase Contrast MRI Technique in Detecting Cerebrospinal Fluid Flow. Medical Research Archives, [S.l.], v. 13, n. 3, mar. 2025. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/6391>. Date accessed: 06 apr. 2025. doi: https://doi.org/10.18103/mra.v3i3.6391.
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Issue
Vol 13 No 3 (2025): Vol.13, Issue 3, March 2025
Section
Research Articles

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References

1. Anagnostakou V, Epshtein M, Ughi GJ, et al. Transvascular in vivo microscopy of the subarachnoid space. J Neurointerv Surg. 2022;14(5):420-428.
2. Ichimura T, Fraser PA, Cserr HF. Distribution of extracellular tracers in perivascular spaces of the rat brain. Brain Res. 1991;545(1-2):103-113.
3. Koh L, Zakharov A, Johnston M. Integration of the subarachnoid space and lymphatics: is it time to embrace a new concept of cerebrospinal fluid absorption? Cerebrospinal Fluid Res. 2005;2:1.
4. Bradley WG Jr, Scalzo D, Queralt J, et al. Normal-pressure hydrocephalus: evaluation with cerebrospinal fluid flow measurements at MR imaging. Radiology. 1996;198(2):523-529.
5. Bradley WG Jr, Whittemore AR, Kortman KE, et al. Marked cerebrospinal fluid void: indicator of successful shunt in patients with suspected normal-pressure hydrocephalus. Radiology. 1991;178(2):459-466.
6. Lindstrøm EK, Ringstad G, Mardal KA, Eide PK. Cerebrospinal fluid volumetric net flow rate and direction in idiopathic normal pressure hydrocephalus. Neuroimage Clin. 2018;20:731-741.
7. Martin BA, Kalata W, Shaffer N, et al. Hydrodynamic and longitudinal impedance analysis of cerebrospinal fluid dynamics at the craniovertebral junction in type I Chiari malformation. PLoS One. 2013;8(10):e75335.
8. Heiss JD, Snyder K, Peterson MM, et al. Pathophysiology of primary spinal syringomyelia. J Neurosurg Spine. 2012;17(5):367-380.
9. Bapuraj JR, Londy FJ, Delavari N, et al. Cerebrospinal fluid velocity amplitudes within the cerebral aqueduct in healthy children and patients with Chiari I malformation. J Magn Reson Imaging. 2016;44(2):463-470.
10. Korbecki A, Zimny A, Podgórski P, et al. Imaging of cerebrospinal fluid flow: fundamentals, techniques, and clinical applications of phase-contrast magnetic resonance imaging. Pol J Radiol. 2019;84:e240.
11. Watts R, Steinklein JM, Waldman L, et al. Measuring glymphatic flow in man using quantitative contrast-enhanced MRI. AJNR Am J Neuroradiol. 2019;40(4):648-651.
12. Ahmad N, Salama D, Al-Haggar M. MRI CSF flowmetry in evaluation of different neurological diseases. Egypt J Radiol Nucl Med. 2021;52:1-10.
13. Sakhare AR, Barisano G, Pa J. Assessing test-retest reliability of phase contrast MRI for measuring cerebrospinal fluid and cerebral blood flow dynamics. Magn Reson Med. 2019;82(2):658-670.
14. Govindarajan BR, Sharma PK, Polaka Y, et al. The role of phase-contrast MRI in diagnosing cerebrospinal fluid flow abnormalities. Cureus. 2024;16(3):e57114.
15. Elsafty HG, ELAggan AM, Yousef MA, et al. Cerebrospinal fluid flowmetry using phase-contrast MRI technique and its clinical applications. Tanta Med J. 2018;46(2):121-132.
16. Kahlon B, Annertz M, Ståhlberg F, Rehncrona S. Is aqueductal stroke volume, measured with cine phase-contrast magnetic resonance imaging scans, useful in predicting outcome of shunt surgery in suspected normal pressure hydrocephalus? Neurosurgery. 2007;60(1):124-130.
17. Battal B, Kocaoglu M, Bulakbasi N, et al. Cerebrospinal fluid flow imaging by using phase-contrast MR technique. Br J Radiol. 2011;84(1004):758-765.
18. Stankovic Z, Allen BD, Garcia J, et al. 4D flow imaging with MRI. Cardiovasc Diagn Ther. 2014;4(2):173-192.
19. ElSankari S, Balédent O, Van Pesch V, et al. Concomitant analysis of arterial, venous, and CSF flows using phase-contrast MRI: a quantitative comparison between MS patients and healthy controls. J Cereb Blood Flow Metab. 2013;33(9):1314-1321.
20. Schroth G, Klose U. Cerebrospinal fluid flow. Neuroradiology. 1992;35(1):16-24.
21. Kedarasetti RT, Turner KL, Echagarruga C, et al. Functional hyperemia drives fluid exchange in the paravascular space. Fluids Barriers CNS. 2020;17:1-25.
22. Stoquart-ElSankari S, Balédent O, Gondry-Jouet C, et al. Aging effects on cerebral blood and cerebrospinal fluid flows. J Cereb Blood Flow Metab. 2007;27(9):1563-1572.
23. Scollato A, Tenenbaum R, Bahl G, et al. Changes in aqueductal CSF stroke volume and progression of symptoms in patients with unshunted idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2008;29(1):192-197.
24. Chen L, Elias G, Yostos MP, et al. Pathways of cerebrospinal fluid outflow: a deeper understanding of resorption. Neuroradiology. 2015;57:139-147.
25. Dreha-Kulaczewski S, Joseph AA, Merboldt KD, et al. Inspiration is the major regulator of human CSF flow. J Neurosci. 2015;35(6):2485-2491.
26. Addicott MA, Yang LL, Peiffer AM, et al. The effect of daily caffeine use on cerebral blood flow: how much caffeine can we tolerate? Hum Brain Mapp. 2009;30(10):3102-3114.
27. Schrauben EM, Johnson KM, Huston J, et al. Reproducibility of cerebrospinal venous blood flow and vessel anatomy with the use of phase contrast–vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA. AJNR Am J Neuroradiol. 2014;35(5):999-1006.
28. Mancini M, Lanzillo R, Liuzzi R, et al. Internal jugular vein blood flow in multiple sclerosis patients and matched controls. PLoS One. 2014;9(3):e92730.
29. Fushimi Y, Okada T, Okuchi S, et al. Jugular venous reflux on magnetic resonance angiography and radionuclide venography. Acta Radiol Open. 2016;5(12):2058460116681209.