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Volume 12 Supplement 1

Abstracts from Hydrocephalus 2015

  • Poster presentation
  • Open Access

MRI Visualization of CSF Flow

  • 1Email author,
  • 2,
  • 3,
  • 2,
  • 2 and
  • 1
Fluids and Barriers of the CNS201512 (Suppl 1) :P33

https://doi.org/10.1186/2045-8118-12-S1-P33

  • Published:

Keywords

  • Magnetic Resonance Imaging
  • Central Nervous System
  • Spinal Fluid
  • Likelihood Ratio
  • False Negative

Introduction

The ability to non-invasively establish patency of cerebral spinal fluid (CSF) flow between adjacent central nervous system (CNS) compartments is of importance in the diagnosis and treatment of patients with various areas of CSF flow obstruction. Recent advances in magnetic resonance imaging (MRI) technology allows for real-time magnetic labeling of CSF to directly visualize flow through different compartments.

Methods

The presence of CSF flow was examined at the aqueduct of Sylvius (AS), the foramen of Monro (FM), the floor of the third ventricle (3rd V), and the foramen magnum (FMag) using a modification of arterial spin labeling (ASL). The studies were compared with clinical information and classified as true positive, true negative, false positive, and false negative based on expectation of patency.

Results

A total of 68 flow studies were done on 44 patients. High correlation with true positive was seen at all four sites. No flow was visualized in 25 readings of the AS; in 9 of those cases we expected flow to be present. Table 1.

Table 1

AS

FM

3rd

V

FMag

Positive-True

26/26

8/8

12/12

30/30

False

0/26

0/8

0/12

0/30

Negative-True

16/25

0/2

2/3

1/3

False

9/25

2/2

1/3

2/3

Specificity

100%

0%

100%

100%

Sensitivity

74%

80%

92%

94%

Negative

LR 0.26

Undefined

0.08

0.06

Conclusion

Establishing qualitative patency between adjacent CSF compartments using MRI is possible with a modified ASL technique. This technique has excellent (above 80%) sensitivity, specificity, and negative likelihood ratio in three out of the four regions studied.

Authors’ Affiliations

(1)
Division of Neurosurgery, Children's Hospital, Los Angeles, CA, USA
(2)
Department of Radiology, Children's Hospital, Los Angeles, CA, USA
(3)
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

References

  1. Christian EA, Melamed EF, Peck E, Krieger MD, McComb JG: Surgical Management of Hydrocephalus Secondary to Intraventricular Hemorrhage in the Preterm Infant. J Neurosurg Pediatrics. [Accepted for Publication June 18, 2015]Google Scholar

Copyright

© Melamed et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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