title: Current and emerging MR imaging techniques for the diagnosis and management of CSF flow disorders: a review of phase-contrast and time-spatial labeling inversion pulse.
abstract: This article provides an overview of phase-contrast and time-spatial labeling inversion pulse MR imaging techniques to assess CSF movement in the CNS under normal and pathophysiologic situations. Phase-contrast can quantitatively measure stroke volume in selected regions, notably the aqueduct of Sylvius, synchronized to the heartbeat. Judicious fine-tuning of the technique is needed to achieve maximal temporal resolution, and it has limited visualization of CSF motion in many CNS regions. Phase-contrast is frequently used to evaluate those patients with suspected normal pressure hydrocephalus and a Chiari I malformation. Correlation with successful treatment outcome has been problematic. Time-spatial labeling inversion pulse, with a high signal-to-noise ratio, assesses linear and turbulent motion of CSF anywhere in the CNS. Time-spatial labeling inversion pulse can qualitatively visualize whether CSF flows between 2 compartments and determine whether there is flow through the aqueduct of Sylvius or a new surgically created stoma. Cine images reveal CSF linear and turbulent flow patterns.
authors.affiliation: From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tsuchiya
authors.affiliation: Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California.
authors.forename: W G
authors.initials: WG
authors.lastname: Bradley
authors.affiliation: Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California.
authors.forename: M
authors.initials: M
authors.lastname: Law
authors.affiliation: Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada.
authors.forename: M L
authors.initials: ML
authors.lastname: Winkler
authors.affiliation: Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California.
authors.forename: M T
authors.initials: MT
authors.lastname: Borzage
authors.affiliation: Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois.
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Toshiba America Medical Systems Inc (E.J.K.), Tustin, California ekelly@tams.com.
authors.forename: E J
authors.initials: EJ
authors.lastname: Kelly
authors.affiliation: Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: J G
authors.initials: JG
authors.lastname: McComb
mesh_terms: D001139:Arnold-Chiari Malformation / Q000175:diagnosis* / Q000503:physiopathology; D002535:Cerebral Aqueduct / Q000503:physiopathology; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012212:Rheology / Q000379:methods; D012815:Signal Processing, Computer-Assisted; D059629:Signal-To-Noise Ratio; D062211:Spatio-Temporal Analysis