Novel assessment of cerebrospinal fluid dynamics by time-spatial labeling inversion pulse magnetic resonance imaging in patients with Chiari malformation type I.

Novel assessment of cerebrospinal fluid dynamics by time-spatial labeling inversion pulse magnetic resonance imaging in patients with Chiari malformation type I.

World Neurosurg. 2018 Jan 08;:

Authors: Ohtonari T, Nishihara N, Ota S, Tanaka A

Abstract
OBJECTIVE: We investigated CSF dynamics at CCJ using Time-SLIP MRI to demonstrate the significance of ventral and dorsal combined CSF dynamics in assessing CSF flow disturbance in patients with CM-I.
METHODS: Fifteen examinations were performed in nine cases of CM-I (three females patients; mean age, 24.7 years; age range, 11-46 years) before or after craniocervical decompression. The longitudinal maximum movement of the caudal edge of tagged mid-sagittal CSF at CCJ was measured as a LOM, and total on the ventral and dorsal sides was defined as total LOM.
RESULTS: In eight conditions, where it was concluded that no craniocervical decompression was necessary or where symptoms improved following craniocervical decompression based on the clinical symptoms, total LOM was 49.8±13.1 mm. In contrast, in the seven cases where craniocervical decompression was mandatory, total LOM was 23.2±9.2 mm. Significant differences were identified between the two groups. Total LOM <35.0 mm resulted to indicate the insufficiency of CSF dynamics, because it corresponded to the necessity of craniocervical decompression based on patients' symptoms.
CONCLUSIONS: Time-SLIP MRI enabled clinicians to use novel dynamic indices, such as CSF motions, in addition to the conventional findings acquired by MRI. In particular, it was essential to examine combined ventral and dorsal CSF dynamics in assessing CSF patency at CCJ in patients with CM-I.

PMID: 29325958 [PubMed - as supplied by publisher]

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