Keywords:
Haemodynamics / Flow dynamics, Diagnostic procedure, MR, Neuroradiology brain, CNS
Authors:
M. A. Lucic, M. Bjelan, A. Ragaji, K. Koprivsek, S. Lucic, D. Kozarski, M. Spirovski, V. Njagulj, D. Kozic; Sremska Kamenica/RS
DOI:
10.1594/ecr2013/C-1130
Purpose
Though we have achieved a tremendous improvement in our knowledge of the cerebrospinal fluid (CSF) creation,
circulation,
and absorption during the last decades,
there is still a waste inanity in our understanding of the CSF basic physiology and pathology1.
The fact that some uncertainties regarding the CSF circulation are still present is enhancing the certainty that our understanding of pathological deviations and/or variations from normal CSF flow pathways may still be confined by our insufficient understanding of the fundamental physical and physiological postulates of this phenomenon2-5.
Having in mind that majority of nowadays available diagnostic imaging tools in examination of the patients with CSF flow disorder is usually conditioned by limited technological capabilities of existing equipment6,
radiologists traditional reliance on classical signs of increased volume of CSF compartments leaves the broad space for the question is it possible to establish an accurate radiological diagnosis based on morphometric parameters solely,
or is it founded at the preconceptions derived mostly from the clinical symptomatology of the patient.
As an inevitable consequence,
we are facing the major obstacles in the reliability of diagnosis and the adequacy of treatment in the patients with CSF flow disorders7,
including the patients with communicant hydrocephalus in our daily radiological practice.
In a strong believe that the key of accuracy lies within the concept of hydrodynamics1,8 rather than morphometrics and hydrostatics,
and using the dynamic phase-contrast MRI with the possibility to display the pulsatile CSF flow,
allowing the assessment of the CSF flow amplitudes9-12,
we started on the idea that the quantification of CSF hydrodynamics parameters by use of appropriate post-processing software tools may additionally contribute in differentiation of communicant hydrocephalus.
Therefore,
as the purpose of this investigation we defined to establish the differences in CSF net flow,
average and maximal CSF velocities within the cerebral aqueduct (CA) in the patients with communicant hydrocephalus (CH) in comparison to the group of healthy volunteers without the hydrodynamic disorder (WHD).