title: Quantitative MRI for Rapid and User-Independent Monitoring of Intracranial CSF Volume in Hydrocephalus.
abstract: Quantitative MR imaging allows segmentation of different tissue types and automatic calculation of intracranial volume, CSF volume, and brain parenchymal fraction. Brain parenchymal fraction is calculated as (intracranial volume - CSF volume) / intracranial volume. The purpose of this study was to evaluate whether the automatic calculation of intracranial CSF volume or brain parenchymal fraction could be used as an objective method to monitor volume changes in the ventricles.
  
  
  
  A lumbar puncture with drainage of 40 mL of CSF was performed in 23 patients under evaluation for idiopathic normal pressure hydrocephalus. Quantitative MR imaging was performed twice within 1 hour before the lumbar puncture and was repeated 30 minutes, 4 hours, and 24 hours afterward. For each time point, the volume of the lateral ventricles was manually segmented and total intracranial CSF volume and brain parenchymal fraction were automatically calculated by using Synthetic MR postprocessing.
  
  
  
  At 30 minutes after the lumbar puncture, the volume of the lateral ventricles decreased by 5.6 ± 1.9 mL (P < .0001) and the total intracranial CSF volume decreased by 11.3 ± 5.6 mL (P < .001), while brain parenchymal fraction increased by 0.78% ± 0.41% (P < .001). Differences were significant for manual segmentation and brain parenchymal fraction even at 4 hours and 24 hours after the lumbar tap. There was a significant association using a linear mixed model between change in manually segmented ventricular volume and change in brain parenchymal fraction and total CSF volume, (P < .0001).
  
  
  
  Brain parenchymal fraction is provided rapidly and fully automatically with Synthetic MRI and can be used to monitor ventricular volume changes. The method may be useful for objective clinical monitoring of hydrocephalus.
authors.affiliation: From the Departments of Neuroscience, Neurology (J.V.) johan.virhammar@neuro.uu.se.
authors.forename: J
authors.identifier: 0000-0001-9901-2949
authors.initials: J
authors.lastname: Virhammar
authors.affiliation: Center for Medical Imaging Science and Visualization (M.W.), Linköping University, Linköping, Sweden SyntheticMR (M.W.), Linköping, Sweden.
authors.forename: M
authors.identifier: 0000-0002-3037-4201
authors.initials: M
authors.lastname: Warntjes
authors.affiliation: Department of Pharmacology and Clinical Neuroscience (K.L.), Umeå University, Umeå, Sweden.
authors.forename: K
authors.identifier: 0000-0002-7504-8354
authors.initials: K
authors.lastname: Laurell
authors.affiliation: Surgical Sciences, Radiology (E.-M.L.), Uppsala University, Uppsala, Sweden.
authors.forename: E-M
authors.identifier: 0000-0001-6308-1387
authors.initials: EM
authors.lastname: Larsson
mesh_terms: D000328:Adult; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013129:Spinal Puncture / Q000379:methods