In vitro evaluation of cerebrospinal fluid velocity measurement in type I Chiari malformation: repeatability, reproducibility, and agreement using 2D phase contrast and 4D flow MRI

Fluids and Barriers of the CNS

Eleonora Fornari¹  Gwendolyn Williams²  Bryn A. Martin³  Audrey Fu⁴  Francis Loth⁵  Suraj Thyagaraj⁵  Mark Luciano⁶  John Oshinski⁷  Daniel Giese⁸  Alexander C. Bunck⁸  Francesco Santini⁹ 

[1] CIBM, Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland;Department of Chemical and Biological Engineering, University of Idaho, 875 Perimeter Dr. MC1122, 83844, Moscow, ID, USA;Department of Chemical and Biological Engineering, University of Idaho, 875 Perimeter Dr. MC1122, 83844, Moscow, ID, USA;Alcyone Therapeutics Inc, Lowell, MA, USA;Department of Mathematics and Statistical Science, University of Idaho, 83844, Moscow, ID, USA;Department of Mechanical Engineering, Conquer Chiari Research Center, University of Akron, 44325, Akron, OH, USA;Department of Neurosurgery, John Hopkins University, Baltimore, MD, USA;Department of Radiology and Imaging Sciences, Emory University, 30322, Atlanta, GA, USA;Department of Radiology, University Hospital of Cologne, Cologne, Germany;Division of Radiological Physics, Department of Radiology, University Hospital of Basel, Basel, Switzerland;Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland;

关键词: Cerebrospinal fluid;    Phase contrast;    Magnetic resonance imaging;    Chiari malformation;    Spinal cord;   

DOI  :  10.1186/s12987-021-00246-3

来源: Springer

【 摘 要 】

BackgroundPhase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice for Chiari malformation diagnostics. To improve these diagnostic practices, a better understanding of PC MRI based measurement agreement, repeatability, and reproducibility of CSF dynamics is needed.MethodsAn anatomically realistic in vitro subject specific model of a Chiari malformation patient was scanned three times at five different scanning centers using 2D PC MRI and 4D Flow techniques to quantify intra-scanner repeatability, inter-scanner reproducibility, and agreement between imaging modalities. Peak systolic CSF velocities were measured at nine axial planes using 2D PC MRI, which were then compared to 4D Flow peak systolic velocity measurements extracted at those exact axial positions along the model.ResultsComparison of measurement results showed good overall agreement of CSF velocity detection between 2D PC MRI and 4D Flow (p = 0.86), fair intra-scanner repeatability (confidence intervals ± 1.5 cm/s), and poor inter-scanner reproducibility. On average, 4D Flow measurements had a larger variability than 2D PC MRI measurements (standard deviations 1.83 and 1.04 cm/s, respectively).ConclusionAgreement, repeatability, and reproducibility of 2D PC MRI and 4D Flow detection of peak CSF velocities was quantified using a patient-specific in vitro model of Chiari malformation. In combination, the greatest factor leading to measurement inconsistency was determined to be a lack of reproducibility between different MRI centers. Overall, these findings may help lead to better understanding for application of 2D PC MRI and 4D Flow techniques as diagnostic tools for CSF dynamics quantification in Chiari malformation and related diseases.

【 授权许可】

CC BY