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Volume 12 Supplement 1

Abstracts from Hydrocephalus 2015

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MRI Visualization of CSF Flow


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.


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.


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


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.


  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]

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Correspondence to Edward Frederick Melamed.

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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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Melamed, E.F., Ponrartana, S., Christian, E.A. et al. MRI Visualization of CSF Flow. Fluids Barriers CNS 12 (Suppl 1), P33 (2015).

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