Evaluation of CSF flow dynamics by phase-contrast ultra-high field MRI in different types of hydrocephalus

Euromed Diagnostic, Department of Radiology and Imaging, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova, The IVth Congress of Radiology and Medical Imaging of the Republic of Moldova with international participation, Chisinau, May 31 – June 2, 2018Background: The widespread use of mini-invasive neurosurgical methods for correcting cerebrospinal fluid (CSF) dynamics, dictates the need for its accurate evaluation. The study aimed to evaluate the possibilities of ultra-high field phase-contrast MRI for qualitative and quantitative assessment of CSF dynamics in different types of hydrocephalus. Material and methods: 62 patients were included in the study presenting with either open-type post-traumatic hydrocephalus, normotensive hydrocephalus or occlusion hydrocephalus. A cohort of 20 healthy volunteers served as controls. All patients underwent a brain MRI on a Siemens 3T Magnetom Skyra scanner, using conventional sequences in three projections, phase-contrast MRI protocol and acquiring quantitative and qualitative data: amplitude of the linear velocity (Av) of the CSF flux, ejection volume (VE) and surface of the cerebral aqueduct (A). Results: CSF flow parameters were within normal values in the control group. In occlusive hydrocephalus forms, CSF flow at the aqueduct level was reduced to a minimum or not detectable at all. Considerable increases in the values of the parameters were determined in patients with open-type post-traumatic hydrocephalus (VE-0.27 ± 0.075 ml, Av-11.95 ± 1.1 cm / s) and normotensive hydrocephalus (VE-0.21 ± 0.0764 ml, Av-13.3 ± 0.8cm / s), as compared to the control group. The recorded CSF flow parameters improved postoperatively, reaching the upper limit of the normal values. This was associated with a decrease in volume of the ventricular system and reduction of periventricular edema. Conclusions: Phase-contrast MRI is a relevant method for assessing CSF flow dynamics, guiding the treatment strategy, and postoperative follow-up in patients with hydrocephalus