Learning objectives
To review the recommended imaging protocol and the utility of various MRI pulse sequences in the assessment of paediatric CSF disorders
To illustrate the different MR features of various CSF disorders encountered during diagnosis of CSF disorders and in the course of management.
Background
CSF flow disorders are frequently encountered in children.
Recently the advent in MRI technology has been led to better understanding of CSF flow disorders [1].
Flow sensitive MRI techniques and three-dimensional high-resolution sequences have been applied for functional and anatomical assessment of CSF flow dynamics respectively [2,3].
Hydrocephalus and ventriculomegaly ex-vacuo can be differentiated.
Moreover, these studiescan discriminate between communicating and non-communicating hydrocephalus with accurate localization of the site of obstruction [4].
Assessment of arachnoid cysts and determination of CSF movement alteration in cases with...
Findings and procedure details
MRI protocol
Axial,
sagittal and coronal T2-WI,
axial FLAIR and sagittal T1-WI of the brain (Fig. 1 ) are usually acquired along with 3D-DRIVE (figure 2 Fig. 2 ) and Cine phase-contrast sequences (Fig. 3 Fig. 4 ; videoFig. 5 Fig. 6).
Post contrast T1-WI and T2*-WI may be obtained in selected cases.
Image analysis
· Axial,
coronal T2-WIs and FLAIR are analysed first to document ventriculomegaly and to search for any associated structural abnormalities and white matter signal intensity alterations.
· Axial T2-WI and...
Conclusion
Cine phase-contrast MRI and 3D-DRIVE sequences are crucial imaging techniques for the assessment of CSF motion alterations which is important for proper management of patients with varius CSF flow disorders.
Personal information
Dr.
Shaimaa Abdelsattar Mohammad,
MD
Associate professor of Radiodiagnosis
Department of Diagnostic and interventional Radiology
Pediatric Radiology section
Faculty of Medicine
Ain-Shams University
Dr.Noha Mohamed Osman,
MD
Associate professor of Radiodiagnosis
Department of Diagnostic and interventional Radiology
Pediatric Radiology section
Faculty of Medicine
Ain-Shams University
References
1. Kartal,
MG,
& Algin O (2014) Evaluation of hydrocephalus and other cerebrospinal fluid disorders with MRI: An update.
Insights into Imaging 5: 531–541
2. Battal B,
Kocaoglu M,
Bulakbasi N et al (2011) Cerebrospinal fluid flow imaging by using phase-contrast MR technique.
Br J Radiol 84: 758–765
3. Yamada S,
Tsuchiya K,
Bradley WG et al (2015) Current and emerging
MR imaging techniques for the diagnosis and management of CSF flow disorders: a review of phase-contrast and time-spatial labeling inversion pulse.
Am J Neuroradiol....