Colour-coded echographic flow imaging and spectral analysis of cerebrospinal fluid (CSF) in meningitis and hemorrhage. Part I. Clinical evidence.
Using echographic flow imaging (colour Doppler), flow within ventricular CSF-pathways was discovered in an infant with purulent meningitis. 22 mature and 40 premature infants were then investigated for presence of CSF-flow which was detected in a further 5 infants, all premature. Diagnostic criteria for echographic CSF-flow imaging are: 1. flow signals "within" CSF-pathways; 2. to-and-fro movement of CSF (spectral analysis); 3. specific response of CSF-flow to stimuli (respiration, crying, abdominal palpation); 4. dynamic CSF-imaging related to specific anatomical areas of intracranial CSF-pathways. Echographic detection of CSF-flow depends on optimized adjustment of controls, equipment used, meticulous examination technique and awareness of pitfalls on the part of the examiner. A further prerequisite is the presence of scattering particles within CSF, such as red or white blood cells (minimum concentration in the order of one thousand cells/microL) or air. Although echographic CSF-flow imaging is not applicable for excluding the presence of disease, it appears to be a new diagnostic tool with considerable potential allowing selected early and non-invasive diagnosis of CSF-pathology and giving new insights into CSF-hemodynamics.
Winkler
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Department of Pediatric Radiology, Children's Clinic, University Hospital Eppendorf, Hamburg, FRG.
D000005:Abdomen; D002543:Cerebral Hemorrhage / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging*; D002555:Cerebrospinal Fluid / Q000502:physiology; D003448:Crying / Q000502:physiology; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging*; D010173:Palpation; D012119:Respiration / Q000502:physiology; D012212:Rheology; D013057:Spectrum Analysis