Cine cerebrospinal fluid imaging in multiple sclerosis.
OBJECTIVE
To investigate cerebrospinal fluid (CSF) dynamics in the aqueduct of Sylvius in multiple sclerosis (MS) patients and healthy controls (HC) using cine phase contrast imaging.


METHODS
In all, 67 MS patients (48 relapsing-remitting [RR] and 19 secondary-progressive [SP]), nine patients with clinically isolated syndrome (CIS), and 35 age- and sex-matched HC were examined. CSF flow and velocity measures were quantified using a semiautomated method and compared with clinical and magnetic resonance imaging (MRI) disease outcomes.


RESULTS
Significantly decreased CSF net flow was detected in MS patients compared to HC (-3.7 vs. -7.1 μL/beat, P = 0.005). There was a trend for increased net positive flow between SP, RR, and CIS patients. Altered CSF flow and velocity measures were associated with more severe T1 and T2 lesion volumes, lateral and fourth ventricular volumes, and third ventricular width in MS and CIS patients (P < 0.01 for all). In CIS patients, conversion to clinically definite MS in the following year was related to decreased CSF net flow (P = 0.007). There was a trend between increased annual relapse rate and altered CSF flow/velocity measures in RRMS patients (P < 0.05).


CONCLUSIONS
CSF flow dynamics are altered in MS patients. More severe clinical and MRI outcomes in RRMS and CIS patients relate to altered CSF flow and velocity measures.
Buffalo Neuroimaging Analysis Center, State University of New York, Buffalo, New York, USA.
Christopher
C
Magnano
Claudiu
C
Schirda
Bianca
B
Weinstock-Guttman
David S
DS
Wack
Eric
E
Lindzen
David
D
Hojnacki
Niels
N
Bergsland
Cheryl
C
Kennedy
Pavel
P
Belov
Michael G
MG
Dwyer
Guy U
GU
Poloni
Clive B
CB
Beggs
Robert
R
Zivadinov
D000293:Adolescent; D000328:Adult; D000368:Aged; D002535:Cerebral Aqueduct / Q000473:pathology*; D002555:Cerebrospinal Fluid / Q000166:cytology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult