A new MRI tag-based method to non-invasively visualize cerebrospinal fluid flow

• Published in: Child's nervous system Vol. 34; no. 9; pp. 1677 - 1682
• Main Authors: Borzage, Matthew, Ponrartana, Skorn, Tamrazi, Benita, Gibbs, Wende, Nelson, Marvin D., McComb, J. Gordon, Blüml, Stefan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2018
• Subjects: Medicine; Medicine & Public Health; Multimedia Article; Neurosciences; Neurosurgery; CSF flow; ASL; Cerebrospinal fluid (CSF); CSF dynamics; Hydrocephalus; MRI
• ISSN: 0256-7040; 1433-0350; 1433-0350
• DOI: 10.1007/s00381-018-3845-3

Purpose Abnormal cerebrospinal fluid (CSF) dynamics can produce a number of significant clinical problems to include hydrocephalus, loculated areas within the ventricles or subarachnoid spaces as well as impairment of normal CSF movement between the cranial and spinal compartments that can result in a cerebellar ectopia and hydrosyringomyelia. Thus, assessing the patency of fluid flow between adjacent CSF compartments non-invasively by magnetic resonance imaging (MRI) has definite clinical value. Our objective was to demonstrate that a novel tag-based CSF imaging methodology offers improved contrast when compared with a commercially available application. Methods In a prospective study, ten normal healthy adult subjects were examined on 3T magnets with time-spatial labeling inversion pulse (Time-SLIP) and a new tag-based flow technique—time static tagging and mono-contrast preservation (Time-STAMP). The image contrast was calculated for dark-untagged CSF and bright-flowing CSF. We tested the results with the D’Agostino and Pearson normality test and Friedman’s test with Dunn’s multiple comparison correction for significance. Separately 96 pediatric patients were evaluated using the Time-STAMP method. Results In healthy adults, contrasts were consistently higher with Time-STAMP than Time-SLIP ( p  < 0.0001, in all ROI comparisons). The contrast between untagged CSF and flowing tagged CSF improved by 15 to 34%. In both healthy adults and pediatric patients, CSF flow between adjacent fluid compartments was demonstrated. Conclusions Time-STAMP provided images with higher contrast than Time-SLIP, without diminishing the ability to visualize qualitative CSF movement and between adjacent fluid compartments.