To revisit the physiology of cerebrospinal fluid (CSF) formation and flow.
To describe various artifacts related to CSF circulation encountered in MR evaluation of the spine.
To differentiate them from true pathologies and to highlight their potential diagnostic utility.
Cerebrospinal fluid (CSF) is the colourless fluid which encases the neuraxis.It cushions the brain and spinal cord from injury andserves as an important medium for thetransport of nutrients and wastes.On an average,
the de novo volume of CSF measures 140 mL.
This is superimposed by an average daily production of 500 mL of CSF produced by specialized ependymal tissues known as the choroid plexus found within the ventricles (1,2).
CSF is in a dynamic state of motion,
circulated from the lateral and third ventricles into...
Findings and procedure details
Commonly encountered artifacts on MRI due to CSF circulation are as follows:
I) GHOST ARTIFACTS
Phase mismapping or ‘Ghosting’ isa most common artifact due to CSF circulation.
It is recognized by the replication ('ghosts') of the moving anatomy across the image in the direction of the phase encoding gradient (4).
The time duration during the acquisition of adjacent points following the application of the phase encoding gradient (PEG) is long (equal to the repetition time used).
During this time,
changes in the positionof anatomy...
CSF flow artifacts are commonplace in clinical practice,
hencethorough knowledge of these artifacts is beneficial.
Though they aid in identifying few abnormalities,
they tend to be a source of misinterpretations,
especially among radiologists-in-training.
Clinical Fellow,Department of Neuroradiology,
National Neuroscience Institute,Singapore.
Consultant,Department of Neuroradiology,
National Neuroscience Institute,
Normal MRI Appearance and Motion-Related Phenomena of CSF.
American Journal of Roentgenology.
Flowing cerebrospinal fluid in normal and hydrocephalic states: appearance on MR images.
"Anatomy and physiology of cerebrospinal fluid".European Annals of Otorhinolaryngology,
Head and Neck Diseases.128(6): 309–316.
MRI in Practice.
Somerset: John Wiley & Sons; 2019.