Quantitative Analysis of Cerebrospinal Fluid Flow Dynamics in Syringomyelia Associated with Chiari I Malformation

Summary

Two-dimensional phase-contrast (2D-PC) images can be used to evaluate cerebrospinal fluid (CSF) flow dynamics. The fast and active movement of CSF corresponds to cardiac pulsation. This report concerns the quantitative analysis of CSF flow dynamics using 2D-PC images. Since September 1996, we have obtained 35 2D-PC images each from 19 patients. We measured craniocaudal maximum CSF flow (peak velocity) and the position of peak velocity as a percentage of the R-R interval of the cardiac cycle (peak velocity position). In normal volunteers, peak velocity and peak velocity position were 4.67 cm/s and 19.3%, respectively, at the foramen magnum and 4.73 cm/s and 17.5% at the spinal subarachnoid space. In the 14 cases of syringomyelia, preoperative 2D-PC images showed delayed peak velocity position. Postoperative 2D-PC images showed shortened peak velocity position in improved patients. Preoperative CSF flow velocity in syringes was low and showed a phase contrary to that in the subarachnoid space. Postoperative CSF dynamics in syringes showed a normal pulsate pattern, although peak velocity was still low. 2D-PC images are useful for the evaluation of CSF flow dynamics and prediction of surgical results.