Abstract
BACKGROUND AND PURPOSE: Measuring transmantle pressure, the instantaneous pressure difference between the lateral ventricles and the cranial subarachnoid space, by intracranial pressure sensors has limitations. The aim of this study was to compute transmantle pressure noninvasively with a novel nondimensional fluid mechanics model in volunteers and to identify differences related to age and aqueductal dimensions.
MATERIALS AND METHODS: Brain MR images including cardiac-gated 2D phase-contrast MR imaging and fast-spoiled gradient recalled imaging were obtained in 77 volunteers ranging in age from 25–92 years of age. Transmantle pressure was computed during the cardiac cycle with a fluid mechanics model from the measured aqueductal flow rate, stroke volume, aqueductal length and cross-sectional area, and heart rate. Peak pressures during caudal and rostral aqueductal flow were tabulated. The computed transmantle pressure, aqueductal dimensions, and stroke volume were estimated, and the differences due to sex and age were calculated and tested for significance.
RESULTS: Peak transmantle pressure was calculated with the nondimensional averaged 14.4 (SD, 6.5) Pa during caudal flow and 6.9 (SD, 2.8) Pa during rostral flow. It did not differ significantly between men and women or correlate significantly with heart rate. Peak transmantle pressure increased with age and correlated with aqueductal dimensions and stroke volume.
CONCLUSIONS: The nondimensional fluid mechanics model for computing transmantle pressure detected changes in pressure related to age and aqueductal dimensions. This novel methodology can be easily used to investigate the clinical relevance of the transmantle pressure in normal pressure hydrocephalus, pediatric communicating hydrocephalus, and other CSF disorders.
ABBREVIATIONS:
- FSPGR
- fast-spoiled gradient recalled
- PC
- phase-contrast
- VENC
- velocity encoding
Footnotes
This work was supported by the National Institute of Neurological Disorders and Stroke through contract No. 1R01NS120343-01. E.C.-H. acknowledges the partial financial support provided by Fundación Bancaria “la Caixa” (ID 100010434) through “la Caixa” fellowship (LCF/BQ/US12/10110011).
Disclosures: Stephanie J. Sincomb—RELATED: Grant: National Institutes of Health/National Institute of Neurological Diseases and Stroke, Comments: 1R01NS120343-01.* Kevin King—RELATED: Grant: Rudi Schulte Research Institute, Comments: Part of my time overseeing imaging for this project was related to research I was conducting for the Rudi Schulte Research Institute, whose primary goal was to understand biomarkers of normal pressure hydrocephalus.* and National Institutes of Health/National Institute of Neurological Diseases and Stroke, Comments: 1R01NS120343-01.* Matthew Borzage—RELATED: Grant: National Institutes of Health/National Institute of Neurological Diseases and Stroke, Comments: The Grant from the National Institutes of Health/National Institute of Neurological Diseases and Stroke that supports our study is 1R01NS120343-01. Antonio L. Sanchez—RELATED: Grant: National Institutes of Health/National Institute of Neurological Diseases and Stroke, Comments: 1R01NS120343-01.* Juan C. Lasheras—RELATED: Grant: National Institute for Neurological Diseases and Stroke, Comments: National Institutes of Health grant No. 1R01NS120343-01.* *Money paid to the institution.
- © 2021 by American Journal of Neuroradiology
Indicates open access to non-subscribers at www.ajnr.org