title: Magnetic resonance 4D flow characteristics of cerebrospinal fluid at the craniocervical junction and the cervical spinal canal.
abstract: OBJECTIVE
  To evaluate the applicability of 4D phase contrast (4D PC) MR imaging in the assessment of cerebrospinal fluid dynamics in healthy volunteers and patients with lesions at the craniocervical junction or the cervical spinal canal.
  
  
  METHODS
  Ten healthy volunteers and four patients with lesions including Chiari I malformation and cervical canal stenoses were examined by a cardiac-gated 4D PC imaging sequence on 1.5T MRI. Phase contrast images were postprocessed allowing for flow quantification and flow pathline visualisation. Velocity data were compared with conventional axial 2D phase contrast images.
  
  
  RESULTS
  The 4D PC sequence allowed for flow quantification and visualisation in all individuals. Bland-Altman analysis showed good agreement of 2D and 4D PC velocity data. In healthy volunteers, CSF flow was homogeneously distributed in the anterior and anterolateral subarachnoid space with the flow directed caudally during systole and cranially during diastole. Flow velocities were closely related to the width of the subarachnoid space. Patients showed grossly altered CSF flow patterns with formation of flow jets with increased flow velocities.
  
  
  CONCLUSIONS
  4D PC MR imaging allows for a detailed assessment of CSF flow dynamics helping to distinguish physiological from complex pathological flow patterns at the craniocervical junction and the cervical spine.
authors.affiliation: Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany. alexander.bunck@ukmuenster.de
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Bunck
authors.forename: Jan-Robert
authors.initials: JR
authors.lastname: Kröger
authors.forename: Alena
authors.initials: A
authors.lastname: Jüttner
authors.forename: Angela
authors.initials: A
authors.lastname: Brentrup
authors.forename: Barbara
authors.initials: B
authors.lastname: Fiedler
authors.forename: Frank
authors.initials: F
authors.lastname: Schaarschmidt
authors.forename: Gerard R
authors.initials: GR
authors.lastname: Crelier
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schwindt
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederstadt
authors.forename: David
authors.initials: D
authors.lastname: Maintz
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000503:physiopathology*; D001268:Atlanto-Axial Joint; D002555:Cerebrospinal Fluid / Q000502:physiology*; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D013115:Spinal Canal / Q000502:physiology*; D013130:Spinal Stenosis / Q000503:physiopathology*; D013595:Syringomyelia / Q000503:physiopathology*