Aqueductal cerebrospinal fluid pulsatility in healthy individuals is affected by impaired cerebral venous outflow.
OBJECTIVE
To investigate cerebrospinal fluid (CSF) dynamics in the aqueduct of Sylvius (AoS) in chronic cerebrospinal venous insufficiency (CCSVI)-positive and -negative healthy individuals using cine phase contrast imaging.


METHODS
Fifty-one healthy individuals (32 CCSVI-negative and 19 age-matched CCSVI-positive subjects) were examined using Doppler sonography (DS). Diagnosis of CCSVI was established if subjects fulfilled ≥2 venous hemodynamic criteria on DS. CSF flow and velocity measures were quantified using a semiautomated method and compared with clinical and routine 3T MRI outcomes.


RESULTS
CCSVI was associated with increased CSF pulsatility in the AoS. Net positive CSF flow was 32% greater in the CCSVI-positive group compared with the CCSVI-negative group (P = 0.008). This was accompanied by a 28% increase in the mean aqueductal characteristic signal (ie, the AoS cross-sectional area over the cardiac cycle) in the CCSVI-positive group compared with the CCSVI-negative group (P = 0.021).


CONCLUSIONS
CSF dynamics are altered in CCSVI-positive healthy individuals, as demonstrated by increased pulsatility. This is accompanied by enlargement of the AoS, suggesting that structural changes may be occurring in the brain parenchyma of CCSVI-positive healthy individuals.
Medical Biophysics Laboratory, University of Bradford, Bradford, UK.
Clive B
CB
Beggs
Christopher
C
Magnano
Simon J
SJ
Shepherd
Karen
K
Marr
Vesela
V
Valnarov
David
D
Hojnacki
Niels
N
Bergsland
Pavel
P
Belov
Steven
S
Grisafi
Michael G
MG
Dwyer
Ellen
E
Carl
Bianca
B
Weinstock-Guttman
Robert
R
Zivadinov
D000328:Adult; D000368:Aged; D002535:Cerebral Aqueduct / Q000502:physiology*; D002555:Cerebrospinal Fluid / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis / Q000503:physiopathology*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D020547:Lateral Ventricles / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000503:physiopathology*; D011673:Pulsatile Flow / Q000502:physiology*; D012016:Reference Values; D012984:Software; D013223:Statistics as Topic; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000503:physiopathology*
CCSVI; CSF dynamics; aqueduct of Sylvius; cerebral venous outflow; healthy individuals; lateral ventricle volume