A Phase-Contrast MRI Study to Investigate the Interaction of the CSF Dynamic with the Intracranial CSF Distribution

PURPOSES: Cine PC-MRI has shown that CSF oscillations increase with age, while the ratio between the CSF Oscillation in the aqueduct and the spinal canal is constant. Our aim was to test whether the CSF hydrodynamic can bring complementary information to study pediatric population with an increase of the CSF volume. Material and Method: Forty three patients, newborns and children (mean age: 31 ± 32 months; 5 days - 111 months) with an intracranial CSF volume increase (ventricular or/and subarachnoid spaces) underwent a morphological MRI along with cine PC-MRI to quantify CSF oscillations. We defined a ratio of the ventricular area to that of the intracranial subarachnoid spaces (CSFratio). We also determined an index called CSFdynamic, which equals the CSF aqueduct stroke volume (SVAq) divided by the cervical stroke volume (SVC2C3) at the level C2C3 in the spine. RESULTS: Twenty-three patients presented only ventricular dilatation: CSFdynamic = 20 ± 25; CSFratio: 120 ± 151; with no significant correlation, (rs = 0.152, p = 0.48). Sixteen patients presented both ventricular and subarachnoid space dilations: CSFdynamic = 18 ± 17; CSFratio = 1.67 ± 0.81; with significant positive correlation (rs = 0.5911 p = 0.016). CONCLUSIONS: In pediatric population, the absence of correlation between the dynamic of the CSF and its volume shows that the CSF oscillation does not result only of the size of the ventricles and/or the subarachnoid spaces. The CSF oscillations bring complementary information concerning the active aspect of the CSF