الفهرس 
ANATOMICAL AND PHYSIOLOGICAL BASIS FOR CSF PATHWAYOnly 14 pages are availabe for public view
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Abstract
Cardiac-gated cine Phase contrast MRI has proved to be a noninvasive technique for assessment of the hydrodynamics of the CSF circulation.
It is a useful adjunct to routine MR for clinical study of CSF related diseases as well as for CSF physiology research, and has an aid for differential diagnosis in certain conditions. The phase imaging technique has not been widely employed because of the fact that the anatomic details of the surrounding brain are not well defined. However, with the knowledge that phase imaging is capable of generating actual velocity measurement and has the advantage of providing an attractive cine display of CSF flow, these flow studies will probably assume a greater role in MR imaging.
The technique permits both qualitative and quantitative evaluation of CSF flow. Several quantitative parameters of CSF flow have been investigated, including temporal velocity and volumetric flow parameters.
The technique enables measuring aqueductal flow parameters in a reliable and reproducible way. This enable further understanding of the pathophysiology of abnormal CSF dynamics in cases of NPH .ACSV is a useful tool for the preoperative selection of patients with NPH and for postoperative assessment.
In obstructive hydrocephalus due to aqueductal stenosis, lack of significant aqueductal CSF flow was noticeable. Both the peak systolic velocity and peak diastolic velocities were decreased.
PC MRI techniques provide more physiological data than structural MRI and qualitative assessment of the patency of ventriculostomy. Minor flow in the third ventricle may be an early sign of obstruction.
Symptomatic patients with Chiari I malformations have greater spatial and temporal variation in CSF velocities through the foramen magnum. Peak velocities are increased especially in the anterior subarachnoid space. So phase contrast MR imaging techniques offer more physiological data than simple tonsillar position and qualitative assessment of the patency of the subarachnoid spaces.
In cases of syringomyelia associated with Chiari I malformation, peak velocity position is delayed at the foramen magnum and shows pulsatile flow within the cyst. Diastolic and systolic cyst velocities can assist in the evaluation of the efficacy of surgery.
PC-MRI is able to successfully differentiate between noncommunicating arachnoid cysts and communicating arachnoid cysts and is a valuable diagnostic tool. Bidirectional CSF flow demonstrated the patency of the fistula to evaluate the effectiveness of cystocistern fenestration.
PC-MRI may be helpful as an adjunct to routine MR imaging in the evaluation of the cystic malformations of the posterior fossa, it can improve the differentiation between such malformations.
Conclusion
Phase contrast imaging can be used for quantitative and qualitative CSF flow analysis
It is a useful adjunct to routine MR for clinical study
of CSF related diseases
Phase contrast MRI is essential pre-operative examination for the diagnosis of NPH and also predicting the prognostic outcome in response to shunt surgery.
Using phase contrast MRI help in assessment of communication of arachnoid cyst and postoperative assessment.
Phase contrast MRI gives predictive value in Chiari malformation surgery and assess severity of the disease.
Using phase contrast MRI can assess the efficacy of surgery in syringomyelia
Phase contrast MRI may be helpful in differentiating of cystic posterior fossa malformation