Background The pathophysiology of idiopathic normal pressure hydrocephalus (I-NPH) is still unclear and the diagnosis is sometimes difficult. The aim of this study was to assess the biophysics of I-NPH by measuring intracranial compliance using cine MRI.
Methods The study included patients with I-NPH (I-NPH group, n=13), brain atrophy or asymptomatic ventricular dilation (VD group, n=10), and healthy volunteers (control group, n=13). Net blood flow (bilateral internal carotid and vertebral arteries and jugular veins) and cerebrospinal fluid (CSF) flow in the subarachnoid space at the C2 cervical vertebral level were measured using phase-contrast cine MRI. CSF pressure gradient (PGp–p) and intracranial volume changes (VCp–p) during a cardiac cycle were calculated.
Findings The compliance index (CI=VCp–p/PGp–p) in the I-NPH group was significantly lower than in the control and VD groups, whereas no difference was found between the control and VD groups. CI values of I-NPH patients after the tap test were larger than those before. These results clearly show that the intracranial compliance of I-NPH is relatively low compared to that of brain atrophy or normal subject. The increase of CI after a tap test also supports this finding.
Conclusions It is possible to estimate intracranial compliance as CI non-invasively using cine MRI. CI could become a useful method for the diagnosis of I-NPH.
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References
Alperin NJ, Lee SH, Loth F et al (2000) MR-Intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study. Radiology 217:877–885
Alperin N, Sivaramakrishnan A, Lichtor T (2005) Magnetic resonance imaging-based measurements of cerebrospinal fluid and blood flow as indicators of intracranial compliance in patients with Chiari malformation. J Neurosurg 103:46–52
Bradley WG, Scalzo D, Queralt J et al (1996) Normal pressure hydrocephalus; evaluation with cerebrospinal fluid flow measurements at MR imaging. Radiology 198:523–529
Damasceno BP, Carelli EF, Honorato DC (1997) The predictive value of cerebrospinal fluid tap-test in normal pressure hydro-cephalus. Arq Neuropsiquiatr 55:179–185
Ishikawa M, Guideline Committee for Idiopathic Normal Pressure Hydrocephalus, Japanese Society of Normal Pressure hydro-cephalus (2004) Clinical guidelines for idiopathic normal pressure hydrocephalus. Neurol Med Chir (Tokyo) 44:222–223
Kim DS, Choi JU, Huh R et al (1999) Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus. Child's Nerv Syst 15:461–467
Marmarou A, Black P, Bergsneider N et al (2005) Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date. Acta Neurochir Suppl 95:237–240
Mase M, Yamada K, Banno T et al (1998) Quantitative analysis of CSF flow dynamics using MRI in normal pressure hydrocephalus. Acta Neurochir Suppl 71:350–353
Mase M, Yamada K, Banno T et al (1998) Differential diagnosis of normal pressure hydrocephalus based on CSF flow dynamics study using MRI. Curr Treat Hydroceph 8:13–18
Mase M, Banno T, Yamada K et al (1998) Quantitative measurement of CSF flow velocity in the aqueduct using MRI—experimental simulation and normal value. Curr Treat Hydroceph 8:6–12
Mase M, Miyati T, Yamada K et al (2005) Non-invasive measurement of intracranial compliance using cine MRI in normal pressure hydrocephalus. Acta Neurochir Suppl 95:303–306
Matsumoto T, Nagai H, Kasuga Y et al (1986) Changes in intracranial pressure (ICP) pulse wave following hydrocephalus. Acta Neurochir (Wien) 82:50–56
Miyati T, Mase M, Banno T (2003) Frequency analysis of CSF flow on cine MRI in normal pressure hydrocephalus. Eur Radiol 13:1019–1024
Miyati T, Mase M, Kasai H et al (2007) Noninvasive MRI assessment of intracranial compliance in idiopathic normal pressure hydrocephalus. J Magn Reson Imaging 26:274–278
Ohara S, Nagai H, Matsumoto T (1988) MR imaging of CSF pulsatory flow and its relation to intracranial pressure. J Neurosurg 69:675–682
Urchuk SN, Plewes DB (1995) MR measurement of time-dependent blood pressure variations. J Magn Reson Imaging 5:621–627
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Mase, M. et al. (2008). Noninvasive estimation of intracranial compliance in idiopathic NPH using MRI. In: Steiger, H.J. (eds) Acta Neurochirurgica Supplements. Acta Neurochirurgica Supplementum, vol 102. Springer, Vienna. https://doi.org/10.1007/978-3-211-85578-2_23
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