ArticleJournal of neuroimaging : official journal of the American Society of Neuroimaging
Real-Time 2D Phase-Contrast MRI to Assess Cardiac- and Respiratory-Driven CSF Movement in Normal Pressure Hydrocephalus.
Article in Journal of neuroimaging : official journal of the American Society of Neuroimaging. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Flow 2.0: A Standardized Toolbox for Real-Time Phase-Contrast MRI of Neurofluid Dynamics.Magnetic resonance in medicine · 2026Article
- Towards a Deeper Understanding of Cerebrospinal Fluid Transport in the Optic Nerve Subarachnoid Space: A Computational Approach.Annals of biomedical engineering · 2026Article
- Noninvasive Measurement of Cerebrospinal Fluid Flow in Shunted Hydrocephalus: Protocol for Scanner Calibration and Multisite Data Collection.JMIR research protocols · 2026Article
- Human cerebrospinal fluid net flow enhanced by respiration during the awake state.Nature communications · 2025Article
- CSF-flow prior and after spinal tap test in patients with idiopathic normal pressure hydrocephalus-an exploratory study using real-time phase-contrast MRI.Frontiers in neuroimaging · 2025Article
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Authors and funding
12 authors.
Funding
Abstract
background and purposeIn idiopathic normal pressure hydrocephalus (iNPH) patients, cerebrospinal fluid (CSF) flow is typically evaluated with a cardiac-gated two-dimensional (2D) phase-contrast (PC) MRI through the cerebral aqueduct. This approach is limited by the evaluation of a single location and does not account for respiration effects on flow. In this study, we quantified the cardiac and respiratory contributions to CSF movement at multiple intracranial locations using a real-time 2D PC-MRI and evaluated the diagnostic value of CSF dynamics biomarkers in classifying iNPH patients.
methodsThis study included 37 participants: 16 iNPH, 10 Alzheimer's disease (AD), and 11 cognitively unimpaired (CU) controls. Anatomical and real-time (non-gated) PC images were acquired in a 3T Philips scanner. CSF flow was assessed at the foramen magnum, fourth ventricle, Sylvian fissure, lateral ventricle, and cerebral aqueduct. We calculated three CSF dynamics biomarkers: mean velocity amplitude, cardiac signal power, and respiratory signal power. Biomarkers from each location were evaluated for classifying iNPH versus AD and CU using support vector machine (SVM). A p-value of 0.05 or less was considered statistically significant.
resultsThe velocity amplitude and cardiac signal power were significantly reduced in iNPH compared to CU (p < 0.005) and AD (p < 0.05) at the lateral ventricle. The SVM model using biomarkers from the lateral ventricle performed significantly better at classifying iNPH than the other locations in terms of accuracy (p < 0.005) and diagnostic odds ratio (p < 0.05).
conclusionEvaluation of CSF movement beyond the cerebral aqueduct may aid in identifying patients with and understanding the pathophysiology of iNPH.
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