Cerebrospinal fluid flow waveforms: analysis in patients with Chiari I malformation by means of gated phase-contrast MR imaging velocity measurements

Abstract

Purpose: To determine the features of the cardiac cycle-related cerebrospinal fluid (CSF) flow pulsations in with Chiari I malformation before and after decompressive surgery.

Materials and methods: Fifteen patients and 23 healthy subjects underwent cine phase-contrast magnetic resonance imaging. Ten patients were also examined after decompressive surgery. Four regions of interest were selected in the upper cervical subarachnoid space and premedullary cistern. Velocity and fraction of the cardiac cycle waveforms were plotted, and amplitude, temporal, and CSF displacement parameters were assessed.

Results: In the Chiari I patients, impaired systolic and unaltered diastolic CSF flow pulsations immediately below the foramen magnum were identified. After surgery, the systolic flow pulsations immediately below the foramen magnum improved. Good correlation with post-surgical improvement was observed.

Conclusion: CSF flow waveform analysis helps demonstrate abnormalities in CSF flow at the foramen magnum and the benefits of decompressive surgery in patients with the Chiari I malformation.