title: Usefulness of phase-contrast magnetic resonance imaging for diagnosis and treatment evaluation in patients with SIH.
abstract: BACKGROUND
  Most diagnostic tools for spontaneous intracranial hypotension (SIH) are either invasive or occasionally inconsistent with the clinical condition. In this study, we examined the cerebrospinal fluid (CSF) dynamics in SIH using phase-contrast magnetic resonance (PC-MR) imaging.
  
  
  METHODS
  Seventeen SIH patients and 32 healthy individuals, matched by sex and age, were recruited. Each person underwent brain and PC-MR imaging using 3-Tesla MRI. We evaluated the differences in image parameters among patients during the initial and recovery stages against the status of the control group.
  
  
  RESULTS
  SIH patients had lower CSF flow-volume, flux, peak velocity, and higher systolic-to-diastolic time ratio, as well as systolic-to-diastolic volume ratio compared to the control group and the conditions when they recovered. The flow time and volume of the diastolic phase markedly increased after treatment. The discriminating power of PC-MR for SIH was good. Diffuse pachymeningeal enhancement and venous engorgement were present when their PC-MR values were lower than the cut-off values for SIH diagnosis. The headache scores correlated with the peak velocity and pituitary volume.
  
  
  CONCLUSIONS
  Noninvasive PC-MR could provide valid parameters for diagnosis and treatment follow-up in SIH patients. It may be more sensitive than conventional brain MRI.
authors.affiliation: Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Hsin
authors.initials: H
authors.lastname: Tung
authors.affiliation: Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan, ROC.
authors.forename: Yi-Chu
authors.initials: YC
authors.lastname: Liao
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Chih-Ceng
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan, ROC.
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Chang
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Taiwan, ROC Department of Radiological Technology and Graduate Institute of Radiological Science, Central Taiwan University of Science and Technology, Taiwan, ROC Department of Physical Therapy, Hungkuang University of Technology, Taiwan, ROC Department of Physical Therapy and Assistive Technology, National Yang Ming University, Taiwan, ROC.
authors.forename: Clayton Chi-Chang
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan, ROC.
authors.forename: Po-Lin
authors.initials: PL
authors.lastname: Chen
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Taiwan, ROC Department of Radiology, National Yang-Ming University School of Medicine, Taiwan, ROC hungchiehchen@gmail.com.
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D017217:Blood Patch, Epidural; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009192:Myelography; D012016:Reference Values; D012680:Sensitivity and Specificity; D013599:Systole / Q000502:physiology
keywords: Spontaneous intracranial hypotension (SIH); diffuse pachymeningeal enhancement (DPE); orthostatic headache; phase-contrast magnetic resonance (PC-MR); pituitary volume