Magnetic Resonance Imaging Technique for Visualization of Irregular Cerebrospinal Fluid Motion in the Ventricular System and Subarachnoid Space

World Neurosurg. 2017 Jan:97:523-531. doi: 10.1016/j.wneu.2016.07.062. Epub 2016 Jul 26.


Background: Many studies have shown that cerebrospinal fluid (CSF) behaves irregularly, rather than with laminar flow, in the various CSF spaces. We adapted a modified previously known magnetic resonance imaging technique to visualize irregular CSF motion. Subsequently, we assessed the usefulness and clinical significance of the present method.

Materials and methods: Normal CSF motion in 10 healthy volunteers was visualized with the dynamic improved, motion-sensitized, driven-equilibrium steady-state free precession technique. Subsequently, CSF motion visualization with a modified sequence was applied to 3 patients.

Results: In healthy volunteers, we achieved visualization of the irregularity of CSF flow in the ventricles and spinal canal, whereas CSF motion was diminished in the peripheral part of the intracranial subarachnoid space. In one case, we confirmed the patency of the patient's third ventriculostomy fenestration site. In the other, we verified the usefulness of the proposed sequence for determining the communication between the ventricle or subarachnoid space and the cyst.

Conclusions: Using the present sequence, we obtained images that accentuated CSF motion, which is largely composed of irregular motion. This method does not require pulse triggering or complex post-processing of images and allows visualization of CSF motion in a short period of time in selected whole imaging planes. It can therefore be applied clinically to diagnose various diseases that cause abnormalities in the CSF space.

Keywords: Balanced steady-state free precession; Cerebrospinal fluid; Cerebrospinal fluid motion; Improved motion-sensitized driven-equilibrium; Magnetic resonance imaging.

MeSH terms

  • Adult
  • Cerebral Ventricles / diagnostic imaging*
  • Cerebral Ventricles / physiology
  • Cerebrospinal Fluid / diagnostic imaging*
  • Cerebrospinal Fluid / physiology*
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neuroimaging / methods
  • Reproducibility of Results
  • Rheology / methods*
  • Sensitivity and Specificity
  • Subarachnoid Space / diagnostic imaging*
  • Subarachnoid Space / physiology
  • Young Adult