Visual assessment of cerebrospinal fluid flow dynamics using 3D T2-weighted SPACE sequence-based classification system


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Naldemir İ. F., Karaman A. K., Oğul H., Onbas O.

Acta Radiologica, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2024
  • Doi Number: 10.1177/02841851241288219
  • Journal Name: Acta Radiologica
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, Compendex, EMBASE, MEDLINE
  • Keywords: 3D-SPACE, cerebrospinal fluid, hydrocephalus, Magnetic resonance imaging, signal void
  • Istanbul Medipol University Affiliated: Yes

Abstract

Background: Flow-related signal void artifacts can be visualized on the T2-weighted (T2W) three-dimensional sampling perfection with application-optimized contrast (3D-SPACE) sequence. Flow void artifacts in the cerebral aqueduct and the fourth ventricle can provide information about cerebrospinal fluid (CSF) flow dynamics. Purpose: In this study, we aimed to test the performance of the T2W 3D-SPACE sequence in assessing the CSF flow in the aqueduct and/or fourth ventricle. Material and Methods: A total of 137 patients (age range = 3–89 years) who underwent CSF flow study were included. The amount of signal loss on T2W 3D-SPACE due to flow in the aqueduct and fourth ventricle was assessed and graded using a 4-point scale of 0 (absence of flow void) to 3 (signal void filling the aqueduct and entire fourth ventricle). A correlation was then sought between the quantitative values obtained by phase-contrast magnetic resonance imaging (PC-MRI) and the amount of signal void in the 3D-SPACE sequence. Results: At the aqueduct level, there was a statistically significant difference in the forward flow velocity and the flow volume among different grades (all P < 0.001). In the grade 3 group, CSF peak systolic flow velocity and mean flow volume were found to be significantly higher than in the other grades (P < 0.001). The mean aqueduct area in the grade 0 group was found to be significantly different from that in the other classes (P < 0.001). Conclusion: The amount of signal loss in the fourth ventricle observed on T2W 3D-SPACE is correlated with the peak systolic velocity and flow volume measured quantitatively in PC-MRI.