title: Accuracy of 4D Flow Measurement of Cerebrospinal Fluid Dynamics in the Cervical Spine: An In Vitro Verification Against Numerical Simulation.
abstract: Abnormal alterations in cerebrospinal fluid (CSF) flow are thought to play an important role in pathophysiology of various craniospinal disorders such as hydrocephalus and Chiari malformation. Three directional phase contrast MRI (4D Flow) has been proposed as one method for quantification of the CSF dynamics in healthy and disease states, but prior to further implementation of this technique, its accuracy in measuring CSF velocity magnitude and distribution must be evaluated. In this study, an MR-compatible experimental platform was developed based on an anatomically detailed 3D printed model of the cervical subarachnoid space and subject specific flow boundary conditions. Accuracy of 4D Flow measurements was assessed by comparison of CSF velocities obtained within the in vitro model with the numerically predicted velocities calculated from a spatially averaged computational fluid dynamics (CFD) model based on the same geometry and flow boundary conditions. Good agreement was observed between CFD and 4D Flow in terms of spatial distribution and peak magnitude of through-plane velocities with an average difference of 7.5 and 10.6% for peak systolic and diastolic velocities, respectively. Regression analysis showed lower accuracy of 4D Flow measurement at the timeframes corresponding to low CSF flow rate and poor correlation between CFD and 4D Flow in-plane velocities.
authors.affiliation: Conquer Chiari Research Center, The University of Akron, Akron, OH, USA.|Department of Mechanical Engineering, The University of Akron, Akron, OH, USA.
authors.forename: Soroush
authors.initials: S
authors.lastname: Heidari Pahlavian
authors.affiliation: Department of Radiology, University Hospital of Cologne, Cologne, Germany.|Department of Radiology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Bunck
authors.affiliation: Conquer Chiari Research Center, The University of Akron, Akron, OH, USA.|Department of Mechanical Engineering, 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.
authors.forename: Daniel
authors.initials: D
authors.lastname: Giese
authors.affiliation: Conquer Chiari Research Center, The University of Akron, Akron, OH, USA.|Department of Mechanical Engineering, The University of Akron, Akron, OH, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Loth
authors.affiliation: Department of Radiology, University Hospital of Cologne, Cologne, Germany.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Hedderich
authors.affiliation: Department of Radiology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Jan Robert
authors.initials: JR
authors.lastname: Kröger
authors.affiliation: 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
mesh_terms: D002555:Cerebrospinal Fluid / Q000378:metabolism*; D066193:Cervical Cord / Q000000981:diagnostic imaging / Q000378:metabolism*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism*; D003198:Computer Simulation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008959:Models, Neurological
keywords: 4D Flow measurement; Cerebrospinal fluid; Computational fluid dynamics; Magnetic resonance imaging; Phantom experiment