Value of phase contrast magnetic resonance imaging for investigation of cerebral hydrodynamics.
OBJECTIVE
Phase Contrast Magnetic Resonance Imaging (PCMRI) is a noninvasive technique that can be used to quantify variations of flow during the cardiac cycle. PCMRI allows investigations of blood flow dynamics in the main arteries and veins of the brain but also the dynamics of cerebrospinal fluid. These cerebral flow investigations provide a description of the regulation mechanisms of intracranial pressure during the cardiac cycle. The objective of this paper is to describe the contribution of this technique in diseases related to disorders of cerebral hydrodynamics in the light of 5 clinical cases.


METHODS
Flow measurements were performed using PCMRI sequences on a 1.5 Tesla MR imager in 4 patients with symptomatic ventricular dilation and 1 patient with a syringomyelic cavity.


RESULTS
Flow quantification in these 5 patients, representative of the diseases mainly concerned by cerebral hydrodynamics, is useful to guide the indication for ventricular shunting in patients with hydrocephalus, to demonstrate obstruction of the cerebral aqueduct, to demonstrate recirculation of ventricular CSF after ventriculostomy and to characterize the dynamic features of CSF inside a spinal cavity.


CONCLUSIONS
PCMRI, now available to neurosurgeons, is complementary to morphological MR and provides quantitative information on cerebral hydrodynamics. This information is mainly used to confirm alteration of CSF flow in the cerebral and spinal compartments. PCMRI is also a functional tool to better understand the pathophysiology of hydrocephalus and syringomyelia.
Balédent
O
O
Department of Nuclear Medicine and Imaging, CHU Nord, Place Victor Pauchet, Amiens Cedex, France. olivier.baledent@chu-amiens.fr
Gondry-Jouet
C
C
Stoquart-Elsankari
S
S
Bouzerar
R
R
Le Gars
D
D
Meyer
M E
ME
D000328:Adult; D000368:Aged; D002555:Cerebrospinal Fluid / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000473:pathology / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results
D003287:Contrast Media