title: Cervical compressive myelopathy: flow analysis of cerebrospinal fluid using phase-contrast magnetic resonance imaging.
abstract: To evaluate cerebrospinal fluid (CSF) flow in cervical compressive myelopathy (CCM), by both quantitative and qualitative analyses, using 3T cine phase-contrast magnetic resonance imaging (cine MRI).
  
  
  
  From September, 2014 to June, 2015, we enrolled 45 subjects (18 women and 27 men, mean age, 61.7 ± 13.4 years) to undergo cervical cine MRI. The subjects were divided into three groups: no stenosis and cervical stenosis with and without intramedullary T2 hyperintensity. We measured maximal CSF velocity, and 12 CSF velocity waveforms were plotted per subject. Two readers independently assessed the CSF waveform shape (0 absent; 1 serrated; 2 bi-directional with small amplitude; and 3 normal bi-directional waveform) and the CSF motion pattern (0 absent; 1 interrupted; and 2 intact). The numbers of 12 waveform shapes were summed to yield a CSF waveform score. Linear mixed model and ROC curve analyses were used for statistical analyses.
  
  
  
  Maximal CSF velocity was significantly lower in CCM (marginal mean, 2.72 cm/s) than in stenosis without intramedullary T2 hyperintensity (3.27 cm/s, p = 0.027) and no stenosis (3.80 cm/s, p < 0.001). Bi-phasic CSF motion was lost in cervical stenosis. CSF waveform scores of 17 (area under curve (AUC), 0.797; p = 0.003) and 16.5 (AUC, 0.790; p = 0.004) could predict Japanese Orthopedic Association (JOA) score corresponding to CCM.
  
  
  
  Maximal CSF velocity and CSF waveform score on cine MRI decreased in CCM and was correlated with the JOA score. Thus, both quantitative and qualitative analyses using cine MRI could effectively demonstrate CSF flow alterations in CCM.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Bae
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea. joonwoo2@gmail.com.
authors.forename: Joon Woo
authors.identifier: 0000-0002-7106-5229
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
authors.forename: Ki-Jeong
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D002555:Cerebrospinal Fluid / Q000502:physiology*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Cerebrospinal fluid; Magnetic resonance imaging; Magnetic resonance imaging, cine; Spinal cord; Spinal cord compression