Spinal CSF flow in response to forced thoracic and abdominal respiration

Fluids and Barriers of the CNS

Arun A. Joseph¹  Jens Frahm¹  Jost M. Kollmeier¹  Klaus-Dietmar Merboldt¹  Jutta Gärtner²  Steffi Dreha-Kulaczewski²  Hans-Christoph Ludwig³  Gökmen Aktas⁴ 

[1] Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie;Division of Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen;Division of Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen;School of Medicine, University Medical Center Göttingen;

关键词: Flow-sensitive real-time MRI;    CSF dynamics;    Respiration;    Hydrocephalus;    Intrathoracic pressure;    Intraabdominal pressure;   

DOI  :  10.1186/s12987-019-0130-0

来源: DOAJ

【 摘 要 】

Abstract Background Respiration-induced pressure changes represent a powerful driving force of CSF dynamics as previously demonstrated using flow-sensitive real-time magnetic resonance imaging (MRI). The purpose of the present study was to elucidate the sensitivity of CSF flow along the spinal canal to forced thoracic versus abdominal respiration. Methods Eighteen subjects without known illness were studied using real-time phase-contrast flow MRI at 3 T in the aqueduct and along the spinal canal at levels C3, Th1, Th8 and L3. Subjects performed a protocol of forced breathing comprising four cycles of 2.5 s inspiration and 2.5 s expiration. Results The quantitative results for spinal CSF flow rates and volumes confirm previous findings of an upward movement during forced inspiration and reversed downward flow during subsequent exhalation—for both breathing types. However, the effects were more pronounced for abdominal than for thoracic breathing, in particular at spinal levels Th8 and L3. In general, CSF net flow volumes were very similar for both breathing conditions pointing upwards in all locations. Conclusions Spinal CSF dynamics are sensitive to varying respiratory performances. The different CSF flow volumes in response to deep thoracic versus abdominal breathing reflect instantaneous adjustments of intrathoracic and intraabdominal pressure, respectively. Real-time MRI access to CSF flow in response to defined respiration patterns will be of clinical importance for patients with disturbed CSF circulation like hydrocephalus, pseudotumor cerebri and others.

【 授权许可】

Unknown