title: Inter-operator Reliability of Magnetic Resonance Image-Based Computational Fluid Dynamics Prediction of Cerebrospinal Fluid Motion in the Cervical Spine.
abstract: For the first time, inter-operator dependence of MRI based computational fluid dynamics (CFD) modeling of cerebrospinal fluid (CSF) in the cervical spinal subarachnoid space (SSS) is evaluated. In vivo MRI flow measurements and anatomy MRI images were obtained at the cervico-medullary junction of a healthy subject and a Chiari I malformation patient. 3D anatomies of the SSS were reconstructed by manual segmentation by four independent operators for both cases. CFD results were compared at nine axial locations along the SSS in terms of hydrodynamic and geometric parameters. Intraclass correlation (ICC) assessed the inter-operator agreement for each parameter over the axial locations and coefficient of variance (CV) compared the percentage of variance for each parameter between the operators. Greater operator dependence was found for the patient (0.19 < ICC < 0.99) near the craniovertebral junction compared to the healthy subject (ICC > 0.78). For the healthy subject, hydraulic diameter and Womersley number had the least variance (CV = ~2%). For the patient, peak diastolic velocity and Reynolds number had the smallest variance (CV = ~3%). These results show a high degree of inter-operator reliability for MRI-based CFD simulations of CSF flow in the cervical spine for healthy subjects and a lower degree of reliability for patients with Type I Chiari malformation.
authors.affiliation: Neurophysiological Imaging and Modeling Laboratory, Department of Biological Engineering, The University of Idaho, 875 Perimeter Drive MS 0904, Moscow, ID, 83844-0904, USA. brynm@uidaho.edu.
authors.forename: Bryn A
authors.initials: BA
authors.lastname: Martin
authors.affiliation: Laboratory of Hemodynamics and Cardiovascular Technology, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
authors.forename: Theresia I
authors.initials: TI
authors.lastname: Yiallourou
authors.affiliation: Department of Mechanical Engineering, Conquer Chiari Research Center, The University of Akron, Akron, OH, USA.
authors.forename: Soroush Heidari
authors.initials: SH
authors.lastname: Pahlavian
authors.affiliation: Department of Mechanical Engineering, Conquer Chiari Research Center, The University of Akron, Akron, OH, USA.
authors.forename: Suraj
authors.initials: S
authors.lastname: Thyagaraj
authors.affiliation: Department of Radiology, University Hospital of Cologne, Cologne, Germany.|Department of Clinical Radiology, University of Muenster, Münster, Germany.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Bunck
authors.affiliation: Department of Mechanical Engineering, Conquer Chiari Research Center, The University of Akron, Akron, OH, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Loth
authors.affiliation: Department of Biomedical Engineering, The University of Akron, Akron, OH, USA.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Sheffer
authors.affiliation: Department of Radiology, University Hospital of Cologne, Cologne, Germany.|Department of Clinical Radiology, University of Muenster, Münster, Germany.
authors.forename: Jan Robert
authors.initials: JR
authors.lastname: Kröger
authors.affiliation: Laboratory of Hemodynamics and Cardiovascular Technology, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Stergiopulos
mesh_terms: D001139:Arnold-Chiari Malformation / Q000000981:diagnostic imaging / Q000503:physiopathology; D002555:Cerebrospinal Fluid; D066193:Cervical Cord / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009038:Motion; D015588:Observer Variation
keywords: Cerebrospinal fluid (CSF); Chiari malformation; Computational fluid dynamics (CFD); Magnetic resonance imaging (MRI); Neurohydrodynamics; Subarachnoid space