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

Abstract

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.

Keywords

• Phase-contrast magnetic resonance imaging
• Normal pressure hydrocephalus
• Cerebrospinal fluid