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Cerebrospinal Fluid Flow Waveforms: MR Analysis in Chronic Adult Hydrocephalus

HENRY-FEUGEAS, MARIE-CECILE MD, PhD,*; IDY-PERETTI, ILANA MD, PhD,†; BALEDENT, OLIVIER MS,†; CORNU, PHILIPPE MD,‡; LEJAY, HUBERT MS,§; BITTOUN, JACQUES MD, PhD,∥; SCHOUMAN-CLAEYS, AND ELISABETH MD*

Original Investigations
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Henry-Feugeas MC, Idy-Peretti I, Baledent O, et al. Cerebrospinal fluid flow waveforms: MR analysis in chronic adult hydrocephalus. Invest Radiol 2001;36:146–154.

rationale and objectives.  To analyze changes in cere-brospinal fluid (CSF) hydrodynamics in chronic adult hydrocephalus.

methods. Phase-contrast cine-MR acquisitions were used to explore the ventricular system and the upper ventral cervical spaces of 16 patients. The aqueductal jet was explored in 32 control subjects.

results. The duration of pulsatile caudal CSF flow (ie, CSF systole) was abnormally short in patients with active idiopathic and obstructive hydrocephalus. The duration of CSF cervical systole was normal in patients with stable hydrocephalus. The aqueductal stroke volume could be increased in stable communicating hydrocephalus. Patients who responded to shunting had shortened CSF systoles and hyperpulsatile ventricular patterns. Successful CSF diversion resulted in longer CSF systoles and CSF ventricular patterns that were no longer hyperpulsatile.

conclusions. Magnetic resonance analysis of CSF flow can show craniospinal dissociation and limitation of CSF outflow from the ventricles in both obstructive and communicating hydrocephalus; it should help determine the response to shunting in communicating hydrocephalus.

From the *Laboratoire d’Imagerie Médicale Paris Nord Jeune Equipe 2156, Université Paris VII-Denis Diderot–Faculté de Médecine Xavier Bichat, and Service de Radiologie, Groupe Hospitalier Bichat Claude Bernard, Paris; †Unité de Recherche en Imagerie Médicale, CNRS UMR 6600, Université Picardie Jules Verne, Centre Hospitalo-Universitaire Nord d’Amiens, Amiens; ‡Service de Neurochirurgie, Groupe Hospitalier Pitié Salpêtrière, Paris; §GE Medical Systems, Buc; and ∥Centre InterEtablissement de Résonance Magnetique, CNRS URA 2212, Université Paris Sud, le Kremlin Bicètre, France.

Reprint requests: Ilana Idy-Peretti, MD, PhD, Unite de Recherche en Medicale, C. N. R. S. U. M. R. 6600, Universite Picardie Jules Verne, Centre Hospitalo-Universitaire Nord d’Amiens, F-80054 Amiens Cedex, France; e-mail: ilana.peretti@sa.u-picardie.fr

Received June 30, 2000, and accepted for publication, after revision, October 26, 2000.

© 2001 Lippincott Williams & Wilkins, Inc.