MR imaging of cerebrospinal fluid flow and spinal cord motion in neurologic disorders of the spine.
In summary, MR imaging of CSF and cord motion helps to evaluate diseases affecting cord and CSF motion and to identify the specific pathophysiology involved. A number of significant points have been made. First, MR imaging flow studies can be useful in evaluating CSF spaces and cystic diseases. Second, longitudinal and transverse motions occur in the spinal cord and CSF. Traveling wave motion occurs along the length of the spinal cord. Third, spinal cord tethering is associated with decreased cord velocity and loss of cord displacement at tethering site. Decreased transverse velocities occur with lateral cord tethering to the spinal canal. Fourth, in spinal dysraphism, longitudinal cord velocity is decreased by tethering, and is normal in asymptomatic patients with low conus. Normal cord motion helps to rule out possible tethering in symptomatic dysraphism with hydromyelia. Fifth, in acquired and nonmyelodysplastic symptomatic tethering, spinal cord motion is decreased. Sixth, in symptomatic cord compression, CSF flow and cord motion decrease, but recover after surgical decompression and after compensatory atrophy. Seventh, in asymptomatic spinal stenosis, cord motion is normal or increased. Diffuse spinal stenosis with cord atrophy leads to diffuse cord acceleration and prolonged cord caudal velocity, possibly related to the loss of the transverse mobility of the cord. Finally, focal spinal stenosis leads to focal dynamic cord deformation and can be associated with prominent intramedullary deformations. When compression is severe or symptomatic, cord motion is significantly decreased. Postoperative cases demonstrate good recovery of cord and CSF motion, unless compression or obstruction is still present.
Levy
L M
LM
Neuroimaging Branch, National Institutes of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
D002555:Cerebrospinal Fluid / Q000502:physiology*; D003560:Cysts / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009068:Movement; D013116:Spinal Cord / Q000002:abnormalities / Q000503:physiopathology*; D013117:Spinal Cord Compression / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000503:physiopathology; D016135:Spinal Dysraphism / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology; D013130:Spinal Stenosis / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology; D013595:Syringomyelia / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000503:physiopathology