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Subject Area

General Surgery

Article Type

Original Study

Abstract

Objective The objective of this study was to evaluate cerebrospinal fluid (CSF) flow by phase-contrast technique. Background Multiple CSF flow disorders are present like normal pressure hydrocephalus (NPH), atrophic brain changes, communicating hydrocephalus, aqueductal stenosis, and others. Routine MRI as well as new techniques like steady-state free precession sequence, 2D phase-contrast cine MRI, and 2D time spatial labeling inversion pulse can be used to evaluate these CSF flow disorders. Patients and methods This was a case–control study and included 50 patients and 10 healthy volunteers as a control group. All were referred to the radiodiagnosis departments at Menoufia University Hospital and Tanta University Hospital from July 2017 to August 2019. Results This study revealed that CSF flowmetry can differentiate between NPH and atrophic brain changes by the value of stroke volume, where the normal range was 10–21 μl, and all cases of atrophic brain changes showed stroke volume less than 10 μl, where all cases of NPH showed stroke volume more than 21 μl. This study can also confirm the diagnosis of aqueductal stenosis and differentiate it from communicating hydrocephalus (cases of aqueductal stenosis showed stroke volume less than 10 μl, where communicating hydrocephalus showed stroke volume is between 10 and 1 μl). It was also useful in follow-up of patients with endoscopic third ventriculostomy by detection of stroke volume through the third ventricular floor stoma. Conclusion The study showed usefulness of this investigation for confirmation of diagnosis of various CSF disorders. Cine phase-contrast MRI studies, however, should be interpreted in conjunction with the clinical manifestations and the conventional MRI findings in cases of ventriculomegaly. The technique enables measuring aqueductal flow parameters in a reliable and reproducible way and predicts response to shunting and also allows accurate follow-up results.

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