Non-invasive assessment of cerebrospinal fluid flow dynamics using phase-contrast magnetic resonance imaging in communicating hydrocephalus |
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| Institution: | 1. Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China;2. Department of Neurosurgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China;3. Department of Radiology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China;1. Department of Neurology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands;2. Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands;3. Department of Neurosurgery, Stuttgart Hospital, Stuttgart, Germany;1. South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia;2. Department of Neurosurgery, Wollongong Hospital, Level 4, 304 Crown Street, Wollongong, NSW 2500, Australia;3. Department of Aged Care and Rehabilitation Medicine, Liverpool Hospital, South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia;4. Department of Medical Imaging, Liverpool Hospital, Liverpool, NSW, Australia;1. Department of Neurosurgery, Osaka Red Cross Hospital, Osaka, Japan;2. Department of Radiology, Osaka Red Cross Hospital, Osaka, Japan;1. Jiangyan TCM Hospital of Taizhou City, PR China;2. Sichuan Provincial Laboratory of Orthopaedic Engineering, PR China;3. Jiangsu Province Hospital on Integration of Chinese and Western Medicine, PR China;1. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China;2. National Center for Neuological Disorders, Shanghai 200040, China;3. Neurosurgical Institute of Fudan University, Shanghai 200040, China;4. Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China;5. Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, China;6. Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences (CAMS), Shanghai 200040, China;7. Department of Neurosurgery, Fudan University Huashan Hospital Fujian Campus, Fujian Medical University The First Affiliated Hospital Binhai Campus, National Regional Medical Center, Fuzhou, Fujian 350209, China |
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| Abstract: | This work aims to evaluate the changes in cerebrospinal fluid (CSF) hydrodynamics in patients diagnosed with communicating hydrocephalus. Besides, we establish the relationship between CSF flow dynamic parameters on the midbrain aqueduct and intracranial pressure (ICP). CSF hydrodynamics analysis was performed using Phase-Contrast Magnetic Resonance Imaging (PC‐MRI) techniques on the midbrain aqueduct of 41 patients diagnosed with communicating hydrocephalus and 22 healthy volunteers. The correlation between CSF average flow in the midbrain aqueduct and intracranial pressure measured by Lumbar Puncture (LP) was assessed in patients with hydrocephalus. Pearson correlation coefficient was used to establish the correction between the average CSF flow of midbrain aqueduct and ICP. CSF dynamic parameters of the midbrain aqueduct in hydrocephalus patients, including peak positive velocity (7.348 cm/s), average velocity (0.623 cm/s), average flow (50.799 mm3/s), and regions of interest (ROI) area (9.978 mm2) were significantly higher than in the healthy controls (p < 0.05). This was after adjusting the age, gender, heart rate, systolic blood pressure, diastolic blood pressure, and body mass index. However, only the peak negative velocity of the midbrain aqueduct did not significantly differ between the groups (p = 0.209). A positive correlation was noted between the average flow (AF) of the midbrain aqueducts and ICP in hydrocephalus patients (y (AF) = 0.386× (ICP)−33.738, r = 0.787, p < 0.05). Reference data of CSF flow dynamic parameters was obtained through the PC-MRI in middle-aged healthy volunteers and communicating hydrocephalus patients. Although the sample size was constrained, this study has significant contributions. For instance, a significant correlation was noted between the average CSF flow of the aqueduct and ICP. This therefore provides a reference for clinicians to monitor ICP in patients with hydrocephalus. |
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| Keywords: | Phase-contrast cine MRI (PC-MRI) Hydrocephalus Intracranial pressure (ICP) Cerebrospinal fluid (CSF) |
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