Use of cerebrospinal fluid flow rates measured by phase-contrast MR to differentiate normal pressure hydrocephalus from involutional brain changes

Aim: The aim of our study was to assess the value of cerebrospinal fluid flow rates measured by phase-contrast MR in cases of normal pressure hydrocephalus (NPH) and to differentiate it from brain atrophy. Material and methods: A total of 26 participants were enrolled into this study, consisting of 15 patients considered to have NPH, 6 patients with atrophic dilatation of the ventricular system not proportional with cerebral sulci, and 5 control cases. All cases were studied using 1.5 T MRI scanner between January 2012 and June 2014. Results: In NPH patients with high stroke volume, we reported marked elevation of the systolic peak and mean velocity as well as stroke volume in comparison with healthy volunteers, indicating a hyperdynamic CSF circulation. On the other hand we studied six patients with involutional brain changes who were found to have non-statically significant lower systolic peak velocity, systolic mean velocity and stroke volume values in comparison with healthy volunteers indicating a hypodynamic CSF circulation and a diagnosis of atrophy. Conclusion: The mean CSF flow rate may be useful in the diagnosis and differential diagnosis, and the prediction of the potential benefits of surgical intervention for patients considered to have NPH