title: Visualization of CSF Flow with Time-resolved 3D MR Velocity Mapping in Aqueductal Stenosis Before and After Endoscopic Third Ventriculostomy : A Feasibility Study.
abstract: OBJECTIVE
  The aim of this study was to evaluate timed-resolved three-dimensional (3D) magnetic resonance (MR) velocity mapping as a method for investigation of cerebrospinal fluid (CSF) flow changes in patients with aqueductal stenosis (AS) treated by endoscopic third ventriculostomy (ETV).
  
  
  METHODS
  The MR velocity mapping was performed in 12 AS patients before and after ETV and in 10 healthy volunteers by using a 3-Tesla MR system. Time-resolved 3D MR velocity mapping data were acquired with a standard 3D phase contrast (PC) sequence with cardiac triggering. Values of mean (vmean) and maximum (vpeak) velocity were measured at several ventricular structures using dedicated software.
  
  
  RESULTS
  Of the patients 11 showed a satisfactory clinical improvement after ETV, whereas one patient needed subsequent shunt implantation. All AS patients showed significant hypomotile CSF flow dynamics in the third ventricle when compared to healthy subjects before surgery (p < 0.05). In contrast, CSF flow velocity was increased within the Foramen of Monro in AS patients. After ETV, all AS patients showed a decrease of CSF flow dynamics within the third ventricle. Mean and peak CSF flow velocities through the ventriculostomy were 1.72 ± 0.59 cm/s (vmean) and 3.53 ± 0.79 cm/s (vpeak), respectively after ETV. The patient who needed shunt implantation after ETV had the lowest flow velocities through the ventriculostomy.
  
  
  CONCLUSIONS
  This study demonstrates that timed-resolved 3D MR velocity mapping is a useful imaging investigation for diagnostics and follow-up in patients with AS. This new technique provides an insight into the physiological CSF flow changes related with AS and its treatment.
authors: Department of Neurosurgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany. Sebastian.Brandner@uk-erlangen.de.
authors: Sebastian
authors: S
authors: Brandner
authors: Department of Neurosurgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
authors: Michael
authors: M
authors: Buchfelder
authors: Department of Neurosurgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
authors: Ilker Y
authors: IY
authors: Eyuepoglu
authors: Department of Neuroradiology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany.
authors: Hannes
authors: H
authors: Luecking
authors: Department of Neuroradiology, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany.
authors: Arnd
authors: A
authors: Doerfler
authors: Department of Neurosurgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
authors: Andreas
authors: A
authors: Stadlbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002535:Cerebral Aqueduct / Q000000981:diagnostic imaging*; D002555:Cerebrospinal Fluid / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D007223:Infant; D008297:Male; D008875:Middle Aged; D020542:Third Ventricle; D016896:Treatment Outcome; D014696:Ventriculostomy; D055815:Young Adult
keywords: Aqueductal stenosis; Cerebrospinal fluid; Endoscopic ventriculostomy; Hydrocephalus; Magnetic resonance imaging; Phase contrast imaging; Velocity mapping