Magnetic resonance velocity mapping of 3D cerebrospinal fluid flow dynamics in hydrocephalus: preliminary results.

[hydrocephalus with stenosis of the aqueduct of sylvius]

To investigate the detectability of CSF flow alterations in the ventricular system of patients with hydrocephalus using time-resolved 3 D MR velocity mapping .MR velocity mapping was performed in 21 consecutive hydrocephalus patients and 21 age-matched volunteers using a 3 D phase-contrast (PC ) sequence . Velocity vectors and particle path lines were calculated for visualisation of flow dynamics . CSF flow was classified as "hypomotile flow " if it showed attenuated dynamics and as "hypermotile flow " if it showed increased dynamics compared with volunteers . Diagnostic efficacy was compared with routine 2 D cine PC -MRI .Seven patients showed hypomotile CSF flow : six had non-communicating hydrocephalus due to aqueductal stenosis . One showed oscillating flow between the lateral ventricles after craniotomy for intracranial haemorrhage . Seven patients showed normal flow : six had hydrocephalus ex vacuo due to brain atrophy . One patient who underwent ventriculostomy 10 years ago showed a flow path through the opening . Seven patients showed hypermotile flow : three had normal pressure hydrocephalus , three had dementia , and in one the diagnosis remained unclear . The diagnostic efficacy of velocity mapping was significantly higher except for that of aqueductal stenosis .Our approach may be useful for diagnosis , therapy planning , and follow-up of different kinds of hydrocephalus .