Quantification of Flow of Cerebrospinal Fluid on Basal Level of Brain by a Phase-Contrast MRI Technique

Here we present on the ability of phase-contrast magnetic resonance imaging (MRI) to accurately measure dynamic properties of cerebrospinal fluid (CSF) flow on basal level of brain. CSF characteristics were compared in a group of 55 healthy volunteers. MRI study was performed using 1.5 T system with the following parameters: repetition time TR/echo time TE = 14/8.3 ms; flip angle FA = 15°; slice thickness = 4 mm. Velocity values of CSF flow on basal level of brain obtained in the study were statistically analyzed by capturing mean values and building confidence intervals (p = 0.05). Student’s paired t-test was performed to determine significance of the differences between mean values and between caudal and cranial CSF flows. Normal values of mean velocity, mean flux and peak velocity were defined by Q-flow technique. The highest values of CSF flow characteristics were observed in the Sylvian aqueduct and pontomedullaris cistern. Mean velocity and mean flux of caudal CSF flow had significantly higher values compared to the cranial CSF flow in all investigated structures.     

Assessment of the biomechanical state of intracranial tissues by dynamic MRI of cerebrospinal fluid pulsations: a phantom study

We used a cranial phantom to investigate how intracranial mechanical factors [brain compliance and the resistance to the flow of cerebrospinal fluid (CSF)] affect the way in which CSF pulsations are driven by pulsatile transcranial blood flow. Dynamic phase-contrast magnetic resonance imaging (MRI) was used to measure the transfer function between vascular pulsations and pulsatile response of the CSF below the foramen magnum of the phantom. We found that the coupling between the high frequency components of cervical CSF flow and transcranial blood flow was decreased when the phantom was modified to simulate increased brain compliance and increased resistance to CSF flow.     

Temporal and spatial assessment of normal cerebrospinal fluid dynamics with MR imaging

The purpose of this study was to measure normal cerebrospinal fluid (CSF) pulsations within the intracranial and upper cervical subarachnoid spaces and the ventricular system. Phase contrast cine MR sequences were performed in sagittal and axial planes on 13 volunteers with flow encoding in the craniocaudal direction. CSF pulsations displayed considerable variations in healthy subjects, depending both on measurements localization and subjects, with CSF peak velocities ranging from 0 to 7 cm/s. In the subarachnoid spaces, the highest velocities occurred in the anterior location and increased from the cerebellar pontine angle cisterns towards the lower cervical spaces. In the ventricular system, the highest velocities occurred through the aqueduct of Sylvius. CSF flow within the third ventricle seemed to reflect a circular motion. There was a caudal net CSF flow in the aqueduct whereas in the upper cervical spaces net CSF flow was caudal anteriorly and cranial laterally. Velocity profiles of CSF pulsations demonstrated arterial morphology. After the R wave, caudal systolic motion was first observed in the posterior subarachnoid spaces, soon after in the anterior subarachnoid spaces and later in the ventricular system. Considering the morphology of CSF pathways, three successively initiated phenomena may explain the temporal course of CSF motion: the systolic expansion of the main arteries at the base of the brain, the systolic expansion of the cerebrospinal axis and, finally, the systolic expansion of the choroid plexuses.     

Improved cerebrospinal fluid flow measurements using phase contrast balanced steady-state free precession

We present a demonstration of phase contrast balanced steady-state free precession (PC-bSSFP) for measuring cerebrospinal fluid (CSF) flow in the brain and spine, and a comparison of measurements obtained with this technique to conventional phase contrast using incoherent gradient echoes (PC-GRE). With PC-GRE sequences, CSF images suffer from low signal-to-noise ratio (SNR), due to short repetition times required for adequate temporal resolution, and the long relaxation time of CSF. Furthermore, CSF flow is often nonlaminar, causing phase dispersion and signal loss in PC-GRE images. It is hypothesized that PC-bSSFP can improve CSF flow measurements with its high SNR and insensitivity to turbulent flow effects. CSF images acquired from the two techniques were compared in 13 healthy volunteers. Three measures were used to objectively evaluate the PC-bSSFP sequence: the CSF flow percentage, defined as the percentage of the total CSF region exhibiting pulsatile flow, net stroke volume and SNR. Images acquired with PC-bSSFP demonstrated pulsatile CSF flow in 35.8% (P<.005), 11.2% (P<.05) and 27.8% (P<.0005) more pixels than PC-GRE in the prepontine cistern, anterior and posterior cervical subarachnoid space (SAS), respectively. Likewise, measurements of stroke volume in these regions increased by 61.6% (P<.05), 16.8% (P<.001) and 48.3% (P<.0001), respectively. Similar comparisons in the aqueduct showed no statistical difference in stroke volumes between the two techniques (P=.5). The average gain in SNR was 3.3+/-1.7 (P<.001) in the prepontine cistern, 5.0+/-0.2 (P<.01) at the cervical level and 2.0+/-0.4 (P<.001) in the aqueduct in PC-bSSFP magnitude images over PC-GRE images. In addition to the obvious advantage of increased SNR, these results indicate that PC-bSSFP provides more complete measurements of CSF flow data than PC-GRE. PC-bSSFP can be used as a reliable technique for CSF flow quantification for the characterization of normal and altered intracranial CSF flow patterns.     

A method for MR quantification of flow velocities in blood and CSF using interleaved gradient-echo pulse sequences

The aim of this study was to establish a rapid method for in vivo quantification of a large range of flow velocities using phase information. A basic gradient-echo sequence was constructed, in which flow was encoded along the slice selection direction by variation of the amplitude of a bipolar gradient without changes in sequence timings. The influence of field inhomogeneities and eddy currents was studied in a 1.5 T scanner. From the basic sequence, interleaved sequences for calibration and in vivo flow determination were constructed, and flow information was obtained by pairwise subtraction of velocity-encoded from velocity non-encoded phase images. Calibration was performed in a nongated mode using flow phantoms, and the results were compared with theoretically calculated encoding efficiencies. In vivo flow was studied in healthy volunteers in three different areas using cardiac gating; central blood flow in the great thoracic vessels, peripheral blood flow in the popliteal vessels, and flow of cerebrospinal fluid (CSF) in the cerebral aqueduct. The results show good agreement with results obtained with other techniques. The proposed method for flow determination was shown to be rapid and flexible, and we thus conclude that it seems well suited for routine clinical MR examinations.     

CSF flow artifact reduction using cardiac cycle ordered phase-encoding method

The flow effects appear as a change of phase as well as signal intensity in NMR imaging. Since the flow of blood and CSF (cerebrospinal fluid) is pulsatile due to the heart pumping, their velocities are not constant during NMR imaging. This type of velocity fluctuation such as the blood or CSF flow induces irregular flow-dependent phase shifts, which have been one of the main causes of flow artifacts in NMR imaging. In order to reduce the flow artifacts, especially the CSF flow artifacts, a new cardiac cycle ordered phase encoding method is proposed and has been studied. This proposed technique utilizes the cardiac cycle as a precursor for the phase encoding gradients similar to the ROPE (respiratory ordered phase encoding) technique which has been used for respiratory motion artifact reduction. The basic concept and its applications are discussed together with the experimental results obtained with human volunteers using the KAIS 2.0 2.0 T whole-body NMR imaging system.     

Characterization of cardiac-related noise in fMRI of the cervical spinal cord

Magnetic resonance imaging (MRI) has recently been applied to study spinal cord function in humans. However, spinal functional MRI (fMRI) encounters major technical challenges with cardiac noise being considered a major source of noise. The present study relied on echo-planar imaging of the cervical cord at short TR (TR=250 ms; TE=40 ms; flip=45 degrees), combined with plethysmographic recordings to characterize the spatiotemporal properties of cardiac-induced signal changes in spinal fMRI. Frequency-based analyses examining signal change at the cardiac frequency confirmed mean fluctuations of about 10% (relative to the mean signal) in the spinal cord and surrounding cerebrospinal fluid (CSF), with maximal responses reaching up to 66% in some voxels. A spatial independent component analysis (sICA) confirmed that cardiac noise is an important source of variance in spinal fMRI with several components showing a response coherent with the cardiac frequency spectrum. The time course of the main cardiac components approximated a sinusoidal function tightly coupled to the cardiac systole with at least one component showing a comparable temporal profile across runs and subjects. Spatially, both the frequency-domain analysis and the sICA demonstrated cardiac noise distributed irregularly along the full rostrocaudal extent of the segments scanned with peaks concentrated in the ventral part of the lateral slices in all scans and subjects, consistent with the major channels of CSF flow. These results confirm that cardiac-induced changes are a significant source of noise likely to affect the detection of spinal Blood Oxygen Level Dependent (BOLD) responses. Most importantly, the complex spatiotemporal structure of cardiac noise is unlikely to be accounted for adequately by ad hoc linear methods, especially in data acquired using long TR (i.e. aliasing the cardiac frequency). However, the reliable spatiotemporal distribution of cardiac noise across scanning runs and within subjects may provide a valid means to identify and extract cardiac noise based on sICA methods.     

MRI of pulsatile CSF motion within arachnoid cysts

Flow void due to pulsatile motion of cerebrospinal fluid (CSF) has recently been demonstrated by a variety of magnetic resonance techniques with sensitivity to slow flow. It has been suggested that within fluid collections not communicating with the physiologic CSF space, there is less signal loss than with the physiologic CSF spaces. Utilizing the SSFP MR technique, which is sensitive to flow as slow as 1 mm/sec, we evaluated three patients with isolated arachnoid cysts. Irregular signal loss consistent with fluid motion was noted within all of the cysts, as well as within the physiologic CSF spaces. Definitive anatomic evaluation of these lesions, though, required ventriculography, an invasive technique.     

Magnetic resonance neurography of the lumbosacral plexus at 3 Tesla – CSF-suppressed imaging with submillimeter resolution by a three-dimensional turbo spin echo sequence

PurposeTo investigate magnetic resonance neurography (MRN) of the lumbosacral plexus (LSP) with cerebrospinal fluid (CSF) suppression by using submillimeter resolution for three-dimensional (3D) turbo spin echo (TSE) imaging.Materials and methodsUsing extended phase graph (EPG) analysis, the signal response of CSF was simulated considering dephasing from coherent motion for frequency-encoding voxel sizes ranging from 0.3 to 1.3 mm and for CSF velocities ranging from 0 to 4 cm/s. In-vivo MRN included 3D TSE data with frequency encoding parallel to the feet/head axis from 15 healthy adults (mean age: 28.5 ± 3.8 years, 5 females; acquisition voxel size: 2 × 2 × 2 mm³) and 16 pediatric patients (mean age: 6.7 ± 4.1 years, 7 females; acquisition voxel size: 0.7 × 0.7 × 1.4 mm³) acquired at 3 Tesla. Five of the adults were scanned repetitively with changing acquisition voxel sizes (1 × 2 × 2 mm³, 0.7 × 2× 2 mm³, and 0.5 × 2 × 2 mm³). Measurements of the bilateral ganglion of the L5 nerve root, averaged between sides, as well as the CSF in the thecal sac were obtained for all included subjects and compared between adults and pediatric patients and between voxel sizes, using a CSF-to-nerve signal ratio (CSFNR).ResultsAccording to simulations, the CSF signal is reduced along the echo train for moving spins. Specifically, it can be reduced by over 90% compared to the maximum simulated signal for flow velocities above 2 cm/s, and could be most effectively suppressed by considering a frequency-encoding voxel size of 0.8 mm or less. For in-vivo measurements, mean CSFNR was 1.52 ± 0.22 for adults and 0.10 ± 0.03 for pediatric patients (p < .0001). Differences in CSFNR were significant between measurements using a voxel size of 2 × 2 × 2 mm³ and measurements in data with reduced voxel sizes (p ≤ .0012), with submillimeter resolution (particularly 0.5 × 2 × 2 mm³) providing highest CSF suppression.ConclusionsApplying frequency-encoding voxel sizes in submillimeter range for 3D TSE imaging with frequency encoding parallel to the feet/head axis may considerably improve MRN of LSP pathology in adults in the future because of favorable CSF suppression.     

Natural convection with damped thermal flux in a vertical circular cylinder

Natural convection flows of an incompressible Newtonian fluid inside a circular cylinder are studied. The heat transfer process is described by a generalized fractional constitutive equation for the thermal flux-temperature gradient. Caputo time-fractional derivative operator, which provides the damping of thermal flux, is considered into the studied model.Analytical solutions to the fluid temperature, thermal flux, fluid velocity and volume flow rate are obtained with the integral transforms method (Laplace transform and finite Hankel transform).Temperature behaviors for small and large values of the time t, as well as the post-transient and transient velocity components are determined. The influence of the memory parameter (the order of the time-fractional derivative) on the temperature, thermal flux, velocity and the volume flow rate is numerically and graphically studied.     

Quantification of low-velocity motion using a navigator-echo supported MR velocity-mapping technique: Application to intracranial dynamics in volunteers and patients with brain tumours

Gradient-echo pulse sequences with velocity-encoding gradients of 22.5–25 mT/m, were used for brainmotion and CSF-flow studies. To reduce motion artifacts, a phase-correction technique based on navigator echoes was evaluated. Three patients with right-sided parietal tumours were investigated; one astrocytoma grade III–IV, one astrocytoma grade I–II and one benign meningioma. In healthy volunteers, a maximal brain-tissue velocity of (0.94 ± 0.26) mm/s (mean ± 1SD) was observed, which is consistent with previously presented results. The phase correction was proven useful for reduction of artifacts due to external head movements in modulus and phase images, without loss of phase information related to internal motion. The tissue velocity within the astrocytomas was low during the entire cardiac cycle. An abnormally high rostral velocity component was, however, observed in the brain tissue frontal to the astrocytomas. In all patients, an abnormal CSF flow pattern was observed. The study of brain motion may provide further understanding of the effects of tumours and other pathological conditions in the brain. When considering intracranial motion as a source of error in diffusion/perfusion MRI, the present study suggests that a pathology can alter the properties of brain motion and CSF flow considerably, leading to a more complex impact on diffusion/perfusion images.     

Optimization of the refocusing flip angle in the characterization of cerebrospinal fluid dynamics using multi-spin echo acquisition cine imaging (MUSACI)

PurposeMulti-spin echo acquisition cine imaging (MUSACI) is a method used for cerebrospinal fluid (CSF) dynamics imaging based on the proton phase dispersion and flow void using 3D multi-spin echo imaging. In a previous study, the refocusing flip angle of MUSACI was set at a constant 80°. We conducted the present study to investigate the preservation the CSF signal intensity even in a long echo train and improve the ability to visualize CSF movement by modifying the refocusing flip angle in MUSACI.MethodsThe MUSACI images were acquired in 10 healthy volunteers (7 men and 3 women; age range 24–44 years; mean age 29.4 ± 6.2 years) with a 3.0 Tesla MR scanner. Five refocusing flip angle sets were applied: constant 30°, constant 50°, constant 80°, pseudo-steady state (PSS) 50°–70°–100° (PSS 50°), and PSS 80°–100°–130° (PSS 80°). In all sequences, the in-plane spatial resolution was 0.58 × 0.58 mm², and the CSF movement for one heartbeat was drawn at 80-msec intervals. The signal intensity (SI) of CSF in the lateral ventricle, the foramen of Monro, the third ventricle, the fourth ventricle, and the pons was measured on MUSACI. Pearson's correlation coefficient was calculated between the CSF SI and effective echo time (TE; TE_eff) in the lateral ventricle.ResultsBoth antegrade and retrograde CSF movements on the midsagittal MUSACI images and the retrograde CSF movement in the foramen of Monro was observed in all sequences with the constant flip angles. A strong reverse correlation between the CSF SI in the lateral ventricle and TE_eff values was observed with constant 30° (r = −0.96, p < 0.01), constant 50° (r = −0.97, p < 0.01) and constant 80° (r = −0.88, p < 0.01). A weak positive correlation was observed with PSS 50° (r = 0.28, p = 0.43), and a moderate reverse correlation was observed at PSS 80° (r = −0.60, p = 0.07). The SI values of the foramen of Monro, the third ventricle, and the fourth ventricle were significantly lower than that of the lateral ventricle, and those values were higher than that of the pons in both the constant 80° sequence and the PSS 50° sequence.ConclusionPSS 50° could be the optimal flip angle scheme for MUSACI, because the SI changes due to CSF movement and the SI preservation due to a long echo train were large due to the use of the refocusing flip angle method.     

Applicability of Assessing Narrowing of Spinal Canal Using Quantitative Analysis of CSF Flow

This study evaluated an assessment tool for spinal canal stenosis by analyzing the speed and flow volume of the cerebrospinal fluid (CSF) in patients suffering from spinal canal stenosis, a representative chronic spinal disease. Twenty patients diagnosed with spinal canal stenosis from 1 November 2007 to 29 February 2008 were selected. Twenty applicants without a medical history or abnormalities in a psychological test were selected as the comparison group. The results showed that the change in the speed and flow volume of the CSF in the T-spine 4–5 and L-spine 1–2 and 4–5 levels was lower in the test group than that in the comparison group. On the other hand, the mean flow volume in the test group was higher in both directions than that of the comparison group.     

Constrained modeling for spectroscopic measurement of bi-exponential spin-lattice relaxation of water in vivo

The (1)H NMR water signal from spectroscopic voxels localized in gray matter contains contributions from tissue and cerebral spinal fluid (CSF). A typically weak CSF signal at short echo times makes separating the tissue and CSF spin-lattice relaxation times (T(1)) difficult, often yielding poor precision in a bi-exponential relaxation model. Simulations show that reducing the variables in the T(1) model by using known signal intensity values significantly improves the precision of the T(1) measurement. The method was validated on studies on eight healthy subjects (four males and four females, mean age 21 +/- 2 years) through a total of twenty-four spectroscopic relaxation studies. Each study included both T(1) and spin-spin relaxation (T(2)) experiments. All volumes were localized along the Sylvian fissure using a stimulated echo localization technique with a mixing time of 10 ms. The T(2) experiment consisted of 16 stimulated echo acquisitions ranging from a minimum echo time (TE) of 20 ms to a maximum of 1000 ms, with a repetition time of 12 s. All T(1) experiments consisted of 16 stimulated echo acquisition, using a homospoil saturation recovery technique with a minimum recovery time of 50 ms and a maximum 12 s. The results of the T(2) measurements provided the signal intensity values used in the bi-exponential T(1) model. The mean T(1) values when the signal intensities were constrained by the T(2) results were 1055.4 ms +/- 7.4% for tissue and 5393.5 ms +/- 59% for CSF. When the signal intensities remained free variables in the model, the mean T(1) values were 1085 ms +/- 19.4% and 5038.8 ms +/- 113.0% for tissue and CSF, respectively. The resulting improvement in precision allows the water tissue T(1) value to be included in the spectroscopic characterization of brain tissue.     

Validation of practical diffusion approximation for virtual near infrared spectroscopy using a digital head phantom

Light propagation in the digital head phantom for virtual near infrared spectroscopy and imaging is calculated by diffusion theory. In theory, diffusion approximation is not valid in a low-scattering cerebrospinal fluid (CSF) layer around the brain. The optical path length and spatial sensitivity profile predicted by the finite element method based upon the diffusion theory are compared with those predicted by the Monte Carlo method to validate a practical implementation of diffusion approximation to light propagation in an adult head. The transport scattering coefficient of the CSF layer is varied from 0.01 to 1.0 mm⁻¹ to evaluate the influence of that layer on the error caused by diffusion approximation. The error is practically ignored and the geometry of the brain surface such as the sulcus structure in the digital head phantom scarcely affects the error when the transport scattering coefficient of the CSF layer is greater than 0.3 mm⁻¹.     

MHD oscillatory flow on free convection–radiation through a porous medium with constant suction velocity

Unsteady two-dimensional hydromagnetic free convection and thermal radiation flow of an electrically conducting viscous-incompressible fluid, through a highly porous medium bounded by a vertical plane surface of constant temperature are presented. The Rosseland diffusion approximation is used to describe the radiative heat flux in the energy equation. Expressions for the velocity and temperature are obtained. The free-stream velocity of the fluid vibrates about a mean constant value and the surface absorbs the fluid with constant velocity. Effects of varying R (radiative parameter), G (Grashof number), k′ (permeability of the porous medium) and M (magnetic parameter upon the velocity field and the effect of varying R and Pr (Prandtl number) on the temperature are discussed.     

Measurement of CSF flow using an interferrographic MR technique based on the rare-fast imaging sequence

A fast MR sequence based on the RARE-myelographic technique allows the determination of cerebrospinal fluid (CSF) flow with a flow sensitivity below 1 mm/sec. The method averages flow over the ECG cycle and consequently measures net flow rather than ECG-dependent flow variations. The noninvasivity of this technique and the very short acquisition time of about 5 sec make this sequence a very useful diagnostic tool for a variety of CSF-flow dependent disorders like the determination of different types of hydrocephalus, the control of shunt operations and the assessment of communication pathways between CSF and cysts.     

Time-Resolved Reflectance of an Optical Pulse in Adult Heads Based on the Finite Difference Time Domain (FDTD) Analysis

Time-resolved reflectance of an optical pulse in adult head models including non-scattering cerebrospinal fluid (CSF) has been analyzed by the finite difference time domain (FDTD) analysis formulated by the authors. Averaged light intensity and mean time of flight dependences on the source-detector separations calculated by the FDTD analysis are in good agreement with previous experiments, hybrid finite element method (FEM) and Monte Carlo calculations, which justify the FDTD analysis. Based on the analysis, time-resolved reflectance sensitivities to detect optical property changes in brain have been analyzed. As a result, it has been become clear that the sensitivities to detect absorption changes of brain are enhanced in time-resolved reflectance compared to the sensitivities in averaged light intensity, whereas the sensitivities to detect scattering property changes of brain are almost the same in time-resolved reflectance and in averaged light intensity. © 2005 The Optical Society of Japan     

Effects of vigabatrin intake on brain GABA activity as monitored by spectrally edited magnetic resonance spectroscopy and positron emission tomography

A deficit in gamma-aminobutyric acid (GABA) levels in the brain or the cerebrospinal fluid (CSF) is found in many epilepsy patients. Frequency and severity of seizures may be reduced by treatment with GABA increasing medicaments as e.g. vigabatrin, an irreversible inhibitor of GABA-transaminase. For a better understanding of the associated effects, healthy volunteers were examined with magnetic resonance spectroscopy (MRS) and positron emission tomography (PET) before and after intake of different doses of vigabatrin. For the MRS examinations, a dedicated localized spectral editing method was developed to determine GABA levels. The 11C-flumazenil (FMZ)-PET protocol allowed determination of GABA-A receptor binding. The results show a clear and dose-dependent increase in the brain GABA levels after the medication period as compared to the baseline values. The GABA-A receptor binding, on the other hand, did not change significantly.     

The effect of flow on the piston problem of acoustics

A compressible fluid, bounded on one side by an infinite plane, flows with constant subsonic speed U parallel to the plane, and acoustic disturbances are caused by a small amplitude vibration of a circular piston set in the plane. The effect of the mean flow on this classical radiation problem is investigated and the distant field is expressed in elementary form. For the compact piston, whose radius is small compared with a wavelength, it is confirmed (in agreement with earlier work) that the distant field is not simply that of a point source with strength equal to the displaced volume flux since the piston has an additional blockage effect on the mean flow. The total excess energy flow is calculated for the compact piston with any subsonic mean flow (and also for the non-compact piston with low Mach number mean flow) and is compared with that for the complementary problem of a moving piston in a quiescent fluid. Since this is the previous problem referred to a reference frame that moves with the mean flow, the pressure and velocity fluctuations are as before, but the energy balance is different since the drag force on the piston does work in the latter case.