Insight into the patterns of cerebrospinal fluid flow in the human ventricular system using MR velocity mapping

The patterns of cerebrospinal fluid (CSF) flow within the human ventricular system are still not fully understood in all their complexity. Knowledge is based on either the interpretation of CSF flow curves or computational simulations. Both approaches only provide an incomplete insight into the spatial and temporal dynamics of CSF flow. Time-resolved three-dimensional magnetic resonance velocity mapping has previously been used to investigate normal and pathologic blood flow patterns in the human vascular system. Here we used this technique to study the spatial and temporal dynamics of CSF flow in the ventricular system of 40 normal volunteers. Classification of the patterns of CSF flow based on calculation of three-dimensional particle path lines over the cardiac cycle revealed one uniform flow pattern for the lateral ventricles, three categories for the third and two categories for the fourth ventricle. We found no significant aging effects on either the presence of a specific CSF flow pattern or on CSF flow velocities. Our results provide the first detailed demonstration of the patterns of CSF flow within the human ventricular system.

[1]  Vartan Kurtcuoglu,et al.  Three-dimensional computational modeling of subject-specific cerebrospinal fluid flow in the subarachnoid space. , 2009, Journal of biomechanical engineering.

[2]  M H Buonocore,et al.  Visualizing blood flow patterns using streamlines, arrows, and particle paths , 1998, Magnetic resonance in medicine.

[3]  Benedicto Crespo-Facorro,et al.  Sex differences in the absence of massa intermedia in patients with schizophrenia versus healthy controls , 2001, Schizophrenia Research.

[4]  C Thomsen,et al.  Fourier analysis of cerebrospinal fluid flow velocities: MR imaging study. The Scandinavian Flow Group. , 1990, Radiology.

[5]  Michalis Xenos,et al.  Dynamics of lateral ventricle and cerebrospinal fluid in normal and hydrocephalic brains , 2006, Journal of magnetic resonance imaging : JMRI.

[6]  Jaleel A. Miyan,et al.  Development of the brain: a vital role for cerebrospinal fluid. , 2003, Canadian journal of physiology and pharmacology.

[7]  C. Nicholson.  Signals that go with the flow , 1999, Trends in Neurosciences.

[8]  Maxim Zaitsev,et al.  Visualization of iliac and proximal femoral artery hemodynamics using time‐resolved 3D phase contrast MRI at 3T , 2007, Journal of magnetic resonance imaging : JMRI.

[9]  R R Edelman,et al.  Multiphasic MR imaging: a new method for direct imaging of pulsatile CSF flow. , 1986, Radiology.

[10]  P. Walker,et al.  Semiautomated method for noise reduction and background phase error correction in MR phase velocity data , 1993, Journal of magnetic resonance imaging : JMRI.

[11]  Thomas Brinker,et al.  Multiplicity of cerebrospinal fluid functions: New challenges in health and disease , 2008, Cerebrospinal Fluid Research.

[12]  Jaleel A. Miyan,et al.  Changes in the CSF fluid pathways in the developing rat fetus with early onset hydrocephalus. , 2001, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[13]  G. du Boulay,et al.  Pulsatile movements in the CSF pathways. , 1966, The British journal of radiology.

[14]  Bahattin Hakyemez,et al.  Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging , 2006, Neuroradiology.

[15]  Núria Bargalló,et al.  Functional analysis of third ventriculostomy patency by quantification of CSF stroke volume by using cine phase-contrast MR imaging. , 2005, AJNR. American journal of neuroradiology.

[16]  Vartan Kurtcuoglu,et al.  Mixing and modes of mass transfer in the third cerebral ventricle: a computational analysis. , 2007, Journal of biomechanical engineering.

[17]  E. Bering,et al.  Circulation of the cerebrospinal fluid. Demonstration of the choroid plexuses as the generator of the force for flow of fluid and ventricular enlargement. , 1962, Journal of neurosurgery.

[18]  Dennis Velakoulis,et al.  Adhesio interthalamica in individuals at high-risk for developing psychosis and patients with psychotic disorders , 2008, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[19]  I. Richard,et al.  Intrathecal baclofen in the treatment of spasticity, dystonia and vegetative disorders. , 2007, Acta neurochirurgica. Supplement.

[20]  D N Firmin,et al.  Vortical flow feature recognition: a topological study of in vivo flow patterns using MR velocity mapping. , 1998, Journal of computer assisted tomography.

[21]  G. Silverberg,et al.  Alzheimer's disease, normal‐pressure hydrocephalus, and senescent changes in CSF circulatory physiology: a hypothesis , 2003, The Lancet Neurology.

[22]  B R Rosen,et al.  MR Velocity Imaging by Phase Display , 1985, Journal of computer assisted tomography.

[23]  Henry Brem,et al.  Drug Delivery to the Central Nervous System: A Review , 1992 .

[24]  Gerald Silverberg,et al.  Elevated cerebrospinal fluid pressure in patients with Alzheimer's disease , 2006, Cerebrospinal Fluid Research.

[25]  Paramjit Singh,et al.  Shunt surgery effects on cerebrospinal fluid flow across the aqueduct of Sylvius in patients with communicating hydrocephalus , 2009, Journal of Clinical Neuroscience.

[26]  Gerhard Friehs,et al.  Intrathecal drug delivery for the management of cancer pain: a multidisciplinary consensus of best clinical practices. , 2005, The journal of supportive oncology.

[27]  N J Pelc,et al.  Normal flow patterns of intracranial and spinal cerebrospinal fluid defined with phase-contrast cine MR imaging. , 1991, Radiology.

[28]  E. Bering,et al.  Choroid plexus and arterial pulsation of cerebrospinal fluid; demonstration of the choroid plexuses as a cerebrospinal fluid pump. , 1955, A.M.A. archives of neurology and psychiatry.

[29]  M. Alley,et al.  Comparison of flow patterns in ascending aortic aneurysms and volunteers using four‐dimensional magnetic resonance velocity mapping , 2007, Journal of magnetic resonance imaging : JMRI.

[30]  J. O'connell,et al.  THE VASCULAR FACTOR TN INTRACRANIAL PRESSURE AND THE MAINTENANCE OF THE CEREBROSPINAL FLUID CIRCULATION , 1943 .

[31]  Michalis Nik Xenos,et al.  Pulsatile cerebrospinal fluid dynamics in the human brain , 2005, IEEE Transactions on Biomedical Engineering.

[32]  Ryoong Huh,et al.  Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus , 1999, Child's Nervous System.

[33]  Vartan Kurtcuoglu,et al.  Computational investigation of subject-specific cerebrospinal fluid flow in the third ventricle and aqueduct of Sylvius. , 2007, Journal of biomechanics.

[34]  G. du Boulay,et al.  Further Investigations on Pulsatile Movements in the Cerebrospinal Fluid Pathways , 1972, Acta radiologica: diagnosis.

[35]  M. Alley,et al.  Time-Resolved 3-Dimensional Velocity Mapping in the Thoracic Aorta: Visualization of 3-Directional Blood Flow Patterns in Healthy Volunteers and Patients , 2004, Journal of computer assisted tomography.

[36]  J P Ridgway,et al.  Demonstration of pulsatile cerebrospinal-fluid flow using magnetic resonance phase imaging. , 1987, The British journal of radiology.

[37]  Bahattin Hakyemez,et al.  Phase-contrast cine MRI versus MR cisternography on the evaluation of the communication between intraventricular arachnoid cysts and neighbouring cerebrospinal fluid spaces , 2009, Neuroradiology.

[38]  W G Bradley,et al.  Normal-pressure hydrocephalus: evaluation with cerebrospinal fluid flow measurements at MR imaging. , 1996, Radiology.

[39]  M. Uyar,et al.  The Efficacy of Intrathecal Morphine in Post-thoracotomy Pain Management , 2007, The Journal of international medical research.

[40]  Murat Aksoy,et al.  Time‐resolved 3D quantitative flow MRI of the major intracranial vessels: Initial experience and comparative evaluation at 1.5T and 3.0T in combination with parallel imaging , 2007, Magnetic resonance in medicine.

[41]  P. R. Moran.  A flow velocity zeugmatographic interlace for NMR imaging in humans. , 1982, Magnetic resonance imaging.

[42]  Giovanni de Marco,et al.  Intracranial Fluid Dynamics in Normal and Hydrocephalic States: Systems Analysis With Phase-Contrast Magnetic Resonance Imaging , 2004, Journal of computer assisted tomography.

[43]  Bradley Wg,et al.  Magnetic resonance imaging in the evaluation of cerebrospinal fluid flow abnormalities. , 1992 .

[44]  C. Wilson,et al.  Interruption of the anterior choroidal artery in experimental hydrocephalus. , 1967, Archives of neurology.

[45]  M. Buonocore,et al.  4D magnetic resonance velocity mapping of blood flow patterns in the aorta in young vs. elderly normal subjects , 1999, Journal of magnetic resonance imaging : JMRI.

[46]  D. Feinberg,et al.  Human brain motion and cerebrospinal fluid circulation demonstrated with MR velocity imaging. , 1987, Radiology.

[47]  P. R. Moran,et al.  Verification and evaluation of internal flow and motion. True magnetic resonance imaging by the phase gradient modulation method. , 1985, Radiology.

[48]  M. Yacoub,et al.  Asymmetric redirection of flow through the heart , 2000, Nature.

[49]  Vartan Kurtcuoglu,et al.  Computational modeling of the mechanical behavior of the cerebrospinal fluid system. , 2005, Journal of biomechanical engineering.

[50]  W G Bradley,et al.  Magnetic resonance imaging in the evaluation of cerebrospinal fluid flow abnormalities. , 1992, Magnetic resonance quarterly.

[51]  Peter Boesiger,et al.  3D cine displacement‐encoded MRI of pulsatile brain motion , 2009, Magnetic resonance in medicine.

[52]  F. Velardi,et al.  Communicating hydrocephalus induced by mechanically increased amplitude of the intraventricular cerebrospinal fluid pressure: Experimental studies , 1978, Experimental Neurology.

[53]  P. Boesiger,et al.  SENSE: Sensitivity encoding for fast MRI , 1999, Magnetic resonance in medicine.

[54]  Loïc Fin,et al.  Brain hydrodynamics study by phase‐contrast magnetic resonance imaging and transcranial color doppler , 2006, Journal of magnetic resonance imaging : JMRI.

[55]  M. Mase,et al.  Quantitative analysis of CSF flow dynamics using MRI in normal pressure hydrocephalus. , 1998, Acta neurochirurgica. Supplement.

[56]  K. Scheffler,et al.  In vivo assessment and visualization of intracranial arterial hemodynamics with flow-sensitized 4D MR imaging at 3T. , 2007, AJNR. American journal of neuroradiology.