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      “Flow comp off”: An easy technique to confirm CSF flow within syrinx and aqueduct

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          Abstract

          Flow compensation, a gradient pulse used for artifact reduction, often used to suppress cerebrospinal fluid (CSF) flow artifacts in spinal magnetic resonance imaging (MRI), can be switched off to make the CSF flow voids within syrinx (syringomyelia) and within aqueduct [normal pressure hydrocephalus (NPH)] more obvious (thus confirming CSF flow). It is a simple method which does not require much time or expertise.

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          Most cited references30

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          Normal-pressure hydrocephalus: evaluation with cerebrospinal fluid flow measurements at MR imaging.

          To evaluate magnetic resonance (MR) imaging-based quantitative phase-contrast cerebrospinal fluid (CSF) velocity imaging for prediction of successful shunting in patients with normal-pressure hydrocephalus (NPH). Eighteen patients (mean age, 73 years) with NPH underwent routine MR imaging and CSF velocity MR imaging before ventriculoperitoneal (VP) shunting. The calculated CSF stroke volume and the aqueductal CSF flow void score were compared with the surgical results. All 12 patients with CSF stroke volumes greater than 42 microL responded favorably to CSF shunting. Of the six patients with stroke volumes of 42 microL or less, three improved with shunting while three did not. The relationship between CSF stroke volume greater than 42 microL and favorable response to VP shunting was statistically significant (P < .05). There was no statistically significant relationship between aqueductal CSF flow void score and responsiveness to shunting. CSF velocity MR imaging is useful in the selection of patients with NPH to undergo shunt formation.
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            Cerebrospinal fluid transport: a lymphatic perspective.

            The textbook view that projections of the arachnoid membrane into the cranial venous sinuses represent the primary cerebrospinal fluid (CSF) absorption sites seems incompatible with many clinical and experimental observations. On balance, there is more quantitative evidence suggesting a function for extracranial lymphatic vessels than exists to support a role for arachnoid villi and granulations in CSF transport.
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              Flowing cerebrospinal fluid in normal and hydrocephalic states: appearance on MR images.

              The signal intensity of the cerebrospinal fluid (CSF) in the cerebral aqueduct and lateral ventricles on magnetic resonance (MR) images was evaluated in 16 healthy individuals and in 32 patients with various forms of hydrocephalus (20 with chronic normal pressure hydrocephalus [NPH], seven with acute communicating hydrocephalus, and five with hydrocephalus ex vacuo [atrophy]). The low signal intensity frequently observed in the cerebral aqueduct is believed to reflect the pulsatile motion of CSF, which is related to the cardiac cycle. While this "aqueductal flow void phenomenon" can be observed in healthy individuals, it is most pronounced in patients with chronic, communicating NPH; is less evident in patients with acute, communicating hydrocephalus; and is least evident in patients with atrophy. Ventricular compliance is known to be essentially normal in atrophy; mildly decreased in acute, communicating hydrocephalus; and severely decreased in NPH. The degree of aqueductal signal loss is believed to reflect the velocity of the pulsatile CSF motion, which in turn depends on the relative ventricular compliance and surface area.
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                Author and article information

                Journal
                Indian J Radiol Imaging
                Indian J Radiol Imaging
                IJRI
                The Indian Journal of Radiology & Imaging
                Medknow Publications & Media Pvt Ltd (India )
                0971-3026
                1998-3808
                Jan-Mar 2013
                : 23
                : 1
                : 97-100
                Affiliations
                [1]Government Medical College, Kottayam, Kerala, India
                Author notes
                Correspondence: Dr. Anitha Sen, Radiodiagnosis, Government Medical College, Kottayam, Kerala, India. E-mail: dranithasen@ 123456hotmail.com
                Article
                IJRI-23-97
                10.4103/0971-3026.113626
                3737625
                23986624
                73ca88ac-1ecc-4b42-a895-1f3e406edf1e
                Copyright: © Indian Journal of Radiology and Imaging

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Neuroradiology-Technical Note

                Radiology & Imaging
                flow compensation,csf flow,syringomyelia,normal pressure hydrocephalus
                Radiology & Imaging
                flow compensation, csf flow, syringomyelia, normal pressure hydrocephalus

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