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Review ArticleREVIEW ARTICLE
Open Access

Current and Emerging MR Imaging Techniques for the Diagnosis and Management of CSF Flow Disorders: A Review of Phase-Contrast and Time–Spatial Labeling Inversion Pulse

S. Yamada, K. Tsuchiya, W.G. Bradley, M. Law, M.L. Winkler, M.T. Borzage, M. Miyazaki, E.J. Kelly and J.G. McComb
American Journal of Neuroradiology July 2014, DOI: https://doi.org/10.3174/ajnr.A4030
S. Yamada
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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K. Tsuchiya
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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W.G. Bradley
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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M. Law
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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M.L. Winkler
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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M.T. Borzage
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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M. Miyazaki
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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E.J. Kelly
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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J.G. McComb
From the Department of Neurosurgery (S.Y.), Toshiba Rinkan Hospital, Sagamihara, Kanagawa, Japan; Department of Radiology (K.T.), Kyorin University, Mitaka, Tokyo, Japan; Department of Radiology (W.G.B.), University of California, San Diego, San Diego, California; Department of Neuroradiology (M.L.), University of Southern California, Los Angeles, California; Steinberg Diagnostic Imaging Center (M.L.W.), Las Vegas, Nevada; Division of Neuroradiology (M.T.B.), Department of Radiology, Institute for Maternal Fetal Health, Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (M.T.B.), USC Viterbi School of Engineering, University of Southern California, Los Angeles, California; Toshiba Medical Research Institute (M.M.), Vernon Hills, Illinois; Toshiba America Medical Systems Inc (E.J.K.), Tustin, California; Division of Neurosurgery (J.G.M.), Children's Hospital Los Angeles, Los Angeles, California; and Department of Neurological Surgery (J.G.M.), Keck School of Medicine, University of Southern California, Los Angeles, California.
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Abstract

SUMMARY: This article provides an overview of phase-contrast and time–spatial labeling inversion pulse MR imaging techniques to assess CSF movement in the CNS under normal and pathophysiologic situations. Phase-contrast can quantitatively measure stroke volume in selected regions, notably the aqueduct of Sylvius, synchronized to the heartbeat. Judicious fine-tuning of the technique is needed to achieve maximal temporal resolution, and it has limited visualization of CSF motion in many CNS regions. Phase-contrast is frequently used to evaluate those patients with suspected normal pressure hydrocephalus and a Chiari I malformation. Correlation with successful treatment outcome has been problematic. Time–spatial labeling inversion pulse, with a high signal-to-noise ratio, assesses linear and turbulent motion of CSF anywhere in the CNS. Time–spatial labeling inversion pulse can qualitatively visualize whether CSF flows between 2 compartments and determine whether there is flow through the aqueduct of Sylvius or a new surgically created stoma. Cine images reveal CSF linear and turbulent flow patterns.

Abbreviations

CSP
cavum septi pellucidi
NPH
normal pressure hydrocephalus
PC
phase-contrast
Time-SLIP
time–spatial labeling inversion pulse
Venc
velocity-encoding value
  • © 2015 American Society of Neuroradiology

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Current and Emerging MR Imaging Techniques for the Diagnosis and Management of CSF Flow Disorders: A Review of Phase-Contrast and Time–Spatial Labeling Inversion Pulse
S. Yamada, K. Tsuchiya, W.G. Bradley, M. Law, M.L. Winkler, M.T. Borzage, M. Miyazaki, E.J. Kelly, J.G. McComb
American Journal of Neuroradiology Jul 2014, DOI: 10.3174/ajnr.A4030

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Current and Emerging MR Imaging Techniques for the Diagnosis and Management of CSF Flow Disorders: A Review of Phase-Contrast and Time–Spatial Labeling Inversion Pulse
S. Yamada, K. Tsuchiya, W.G. Bradley, M. Law, M.L. Winkler, M.T. Borzage, M. Miyazaki, E.J. Kelly, J.G. McComb
American Journal of Neuroradiology Jul 2014, DOI: 10.3174/ajnr.A4030
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