Shigeki Yamada, Tomohiro Otani, Satoshi Ii, Hirotaka Ito, Chifumi Iseki, Motoki Tanikawa, Yoshiyuki Watanabe, Shigeo Wada, Marie Oshima, Mitsuhito Mase
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To elucidate how CSF dynamics deteriorate in Hakim's disease, an age-dependent chronic hydrocephalus, flow parameters were estimated from the two MRI sequences to assess CSF motion in the entire intracranial region.</p><p><strong>Methods: </strong>This study included 127 healthy volunteers aged ≥ 20 years and 44 patients with Hakim's disease. On 4D flow MRI for measuring CSF motion, velocity encoding was set at 5 cm/s. For the IVIM MRI analysis, the diffusion-weighted sequence was set at six b-values (i.e., 0, 50, 100, 250, 500, and 1000 s/mm<sup>2</sup>), and the biexponential IVIM fitting method was adapted. The relationships between the fraction of incoherent perfusion (f) on IVIM MRI and 4D flow MRI parameters including velocity amplitude (VA), absolute maximum velocity, stroke volume, net flow volume, and reverse flow rate were comprehensively evaluated in seven locations in the ventricles and subarachnoid spaces. Furthermore, we developed a new parameter for fluid oscillation, the Fluid Oscillation Index (FOI), by integrating these two measurements. In addition, we investigated the relationship between the measurements and indices specific to Hakim's disease and the FOIs in the entire intracranial space.</p><p><strong>Results: </strong>The VA on 4D flow MRI was significantly associated with the mean f-values on IVIM MRI. Therefore, we estimated VA that could not be directly measured on 4D flow MRI from the mean f-values on IVIM MRI in the intracranial CSF space, using the following formula; e<sup>0.2(f-85)</sup> + 0.25. To quantify fluid oscillation using one integrated parameter with weighting, FOI was calculated as VA × 10 + f × 0.02. In addition, the FOIs at the left foramen of Luschka had the strongest correlations with the Evans index (Pearson's correlation coefficient: 0.78). 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引用次数: 0
摘要
背景:利用四维(4D)血流磁共振成像(MRI)和体外非相干运动磁共振成像(IVIM)对脑脊液(CSF)的双向往复运动进行了量化。为了估算整个颅内区域的各种 CSF 运动,我们尝试整合使用两种 MRI 序列计算出的血流参数。为了阐明哈基姆氏病(一种年龄依赖性慢性脑积水)中 CSF 动态是如何恶化的,我们从两个 MRI 序列中估算了血流参数,以评估整个颅内区域的 CSF 运动:这项研究包括 127 名年龄≥ 20 岁的健康志愿者和 44 名哈基姆病患者。在测量 CSF 运动的 4D 流磁共振成像中,速度编码设定为 5 厘米/秒。为了进行 IVIM MRI 分析,弥散加权序列设置为六个 b 值(即 0、50、100、250、500 和 1000 s/mm2),并采用双指数 IVIM 拟合方法。我们全面评估了脑室和蛛网膜下腔七个位置的 IVIM MRI 非相干灌注分数(f)与四维血流 MRI 参数(包括速度振幅(VA)、绝对最大速度、每搏量、净血流量和反向流速)之间的关系。此外,我们还通过整合这两项测量结果,开发了一种新的流体振荡参数--流体振荡指数(FOI)。此外,我们还研究了哈基姆氏病特有的测量值和指数与整个颅内间隙的流体振荡指数之间的关系:结果:4D血流磁共振成像的VA与IVIM磁共振成像的平均f值明显相关。因此,我们根据颅内 CSF 空间 IVIM MRI 的平均 f 值,用以下公式估算了 4D 血流 MRI 无法直接测量的 VA:e0.2(f-85) + 0.25。为了使用一个带权重的综合参数量化流体振荡,FOI 的计算公式为 VA × 10 + f × 0.02。此外,卢氏左孔的 FOI 与埃文斯指数的相关性最强(皮尔逊相关系数:0.78)。与哈基姆氏病有关的其他指数与大脑导水管和双侧卢氏孔的 FOI 显著相关。在年龄≥60岁的健康对照组中,大脑导水管的FOI也有所升高:我们利用四维血流磁共振成像的 VA 值和 IVIM 磁共振成像的 f 值,通过 FOI 估算了健康人和哈基姆病患者整个颅内 CSF 空间的搏动性 CSF 运动。FOI 可用于量化 CSF 振荡。
Modeling cerebrospinal fluid dynamics across the entire intracranial space through integration of four-dimensional flow and intravoxel incoherent motion magnetic resonance imaging.
Background: Bidirectional reciprocal motion of cerebrospinal fluid (CSF) was quantified using four-dimensional (4D) flow magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) MRI. To estimate various CSF motions in the entire intracranial region, we attempted to integrate the flow parameters calculated using the two MRI sequences. To elucidate how CSF dynamics deteriorate in Hakim's disease, an age-dependent chronic hydrocephalus, flow parameters were estimated from the two MRI sequences to assess CSF motion in the entire intracranial region.
Methods: This study included 127 healthy volunteers aged ≥ 20 years and 44 patients with Hakim's disease. On 4D flow MRI for measuring CSF motion, velocity encoding was set at 5 cm/s. For the IVIM MRI analysis, the diffusion-weighted sequence was set at six b-values (i.e., 0, 50, 100, 250, 500, and 1000 s/mm2), and the biexponential IVIM fitting method was adapted. The relationships between the fraction of incoherent perfusion (f) on IVIM MRI and 4D flow MRI parameters including velocity amplitude (VA), absolute maximum velocity, stroke volume, net flow volume, and reverse flow rate were comprehensively evaluated in seven locations in the ventricles and subarachnoid spaces. Furthermore, we developed a new parameter for fluid oscillation, the Fluid Oscillation Index (FOI), by integrating these two measurements. In addition, we investigated the relationship between the measurements and indices specific to Hakim's disease and the FOIs in the entire intracranial space.
Results: The VA on 4D flow MRI was significantly associated with the mean f-values on IVIM MRI. Therefore, we estimated VA that could not be directly measured on 4D flow MRI from the mean f-values on IVIM MRI in the intracranial CSF space, using the following formula; e0.2(f-85) + 0.25. To quantify fluid oscillation using one integrated parameter with weighting, FOI was calculated as VA × 10 + f × 0.02. In addition, the FOIs at the left foramen of Luschka had the strongest correlations with the Evans index (Pearson's correlation coefficient: 0.78). The other indices related with Hakim's disease were significantly associated with the FOIs at the cerebral aqueduct and bilateral foramina of Luschka. FOI at the cerebral aqueduct was also elevated in healthy controls aged ≥ 60 years.
Conclusions: We estimated pulsatile CSF movements in the entire intracranial CSF space in healthy individuals and patients with Hakim's disease using FOI integrating VA from 4D flow MRI and f-values from IVIM MRI. FOI is useful for quantifying the CSF oscillation.
期刊介绍:
"Fluids and Barriers of the CNS" is a scholarly open access journal that specializes in the intricate world of the central nervous system's fluids and barriers, which are pivotal for the health and well-being of the human body. This journal is a peer-reviewed platform that welcomes research manuscripts exploring the full spectrum of CNS fluids and barriers, with a particular focus on their roles in both health and disease.
At the heart of this journal's interest is the cerebrospinal fluid (CSF), a vital fluid that circulates within the brain and spinal cord, playing a multifaceted role in the normal functioning of the brain and in various neurological conditions. The journal delves into the composition, circulation, and absorption of CSF, as well as its relationship with the parenchymal interstitial fluid and the neurovascular unit at the blood-brain barrier (BBB).