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Research ArticleExtracranial Vascular
Open Access

Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast–Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA

E.M. Schrauben, K.M. Johnson, J. Huston, A.M. del Rio, S.B. Reeder, A. Field and O. Wieben
American Journal of Neuroradiology May 2014, 35 (5) 999-1006; DOI: https://doi.org/10.3174/ajnr.A3779
E.M. Schrauben
aFrom the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.)
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K.M. Johnson
aFrom the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.)
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J. Huston
bRadiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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A.M. del Rio
aFrom the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.)
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S.B. Reeder
aFrom the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.)
bRadiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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A. Field
bRadiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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O. Wieben
aFrom the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.)
bRadiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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    Fig 1.

    Example of flow visualization for COM (A). Arrows: yellow indicates left/right transverse sinus; red, sagittal sinus; green, straight sinus; blue, vein of Galen; internal cerebral veins: left (orange), right (white). Planes mark location of flow measurement. Blood flow waveforms (B) exemplify COM at the torcular herophili, with total flow measurements differing by only 0.37%.

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    Fig 2.

    Left: Example placement of measurement planes in the right IJV down a centerline cubic spline and in the left common carotid artery. Right: Blood flow waveforms over the cardiac cycle indicate increasing pulsatility proximal to the heart, with a portion of the lower waveform showing retrograde flow (arrow). A indicates atrial systole; X, atrial relaxation; V, ventricular systole; Y, tricuspid reopening; H, atrial refilling.

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    Fig 3.

    Left: B-mode anatomic location of right IJV blood flow. Right: Doppler ultrasonography displays triphasic IJV blood flow waveform as indicated in Fig 2. Arrow indicates minor normal reflux during the tricuspid valve reopening.

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    Fig 4.

    Interscan Bland-Altman plots for cerebral vein analysis within individual veins. Small biases and LOA indicate reproducibility of PC-VIPR in assessment of cerebral venous flow.

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    Fig 5.

    Bland-Altman plots of COM analysis for scan 1 (left) and scan 2 (right), showing small biases and LOA.

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    Fig 6.

    Boxplot results for all measurement locations. Individual changes (blue lines) show high variation in both the IJV and AV from scan to scan. No differences were considered significant (P < .05).

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    Fig 7.

    Percent change in total flow from scan 1 to scan 2 across volunteers. Volunteers 5–10 have similar directional changes in all measurements.

Tables

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    Table 1:

    Total flow (mL/cardiac cycle), delineated by side, measurement level, and scan, in all volunteers

    VolunteerLeft IJVRight IJV
    UpperMidLowerUpperMidLower
    S1S2S1S2S1S2S1S2S1S2S1S2
    10000001.908.362.007.153.953.07
    24.364.424.452.804.634.116.036.404.563.349.598.47
    33.352.634.391.411.990.31000000
    42.092.820.803.342.143.703.403.022.996.532.788.75
    53.892.031.841.742.461.092.370.462.731.861.470.37
    61.001.680.981.442.262.823.535.372.904.271.393.48
    70.490.460.820.330.570.506.354.314.912.825.253.63
    84.184.773.604.012.954.244.545.393.425.722.695.53
    92.870.742.541.140.640.34000000
    103.093.252.602.591.030.993.993.333.752.351.281.19
    Average/Max %RF0.79/6.152.98/14.396.02/24.590.30/4.831.19/12.313.52/29.46
    • Note:—Average and maximum retrograde flow percentages are presented (bottom row).

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    Table 2:

    Average (± standard deviation) scores from CE-MRA from both radiologists and across all scans

    IJV Image QualityLeft IJV MorphologyRight IJV MorphologyAV Image QualityAV Morphology
    Scoring, average ± standard deviation3.70 ± 0.562.93 ± 1.003.40 ± 1.263.08 ± 0.892.95 ± 0.22
    Interscan κ−0.0640.4740.3660.202−0.053
    Interrater κ−0.042−0.0550.2810.104−
    • Note:—Interscan and interrater agreement is slight or nonexistent across scoring; κ <0 indicates no agreement; 0–0.20, slight; 0.21–0.40, fair; 0.41–0.60, moderate; 0.61–0.80, substantial; 0.81–1, almost perfect.

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American Journal of Neuroradiology: 35 (5)
American Journal of Neuroradiology
Vol. 35, Issue 5
1 May 2014
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E.M. Schrauben, K.M. Johnson, J. Huston, A.M. del Rio, S.B. Reeder, A. Field, O. Wieben
Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast–Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA
American Journal of Neuroradiology May 2014, 35 (5) 999-1006; DOI: 10.3174/ajnr.A3779

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Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast–Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA
E.M. Schrauben, K.M. Johnson, J. Huston, A.M. del Rio, S.B. Reeder, A. Field, O. Wieben
American Journal of Neuroradiology May 2014, 35 (5) 999-1006; DOI: 10.3174/ajnr.A3779
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