CSF Flow Quantification

Purpose	To delineate accurate CSF flow quantification on phase-contrast MRI in a variety of diseases.
Tag(s)
Panel	Neuroradiology Panel
Define-AI ID	21020020
Originator	Mark Lum
Lead	Mark Lum
Panel Chair	Alex Norbash
Panel Reviewers	Neuroradiology Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES185

                               

Value Proposition

Cerebral spinal fluid (CSF) flow assessment is useful in the diagnosis and post-treatment follow-up of several disorders such as normal pressure hydrocephalus, Chiari malformation, and aqueductal stenosis. Phase contrast MRI is a useful tool for the qualitative assessment of CSF flow. Phase contrast imaging can also provide quantitative assessment; however, a main limitation of quantitative analysis is accurate segmentation of the region of interest (e.g. aqueduct, foramen magnum), which is currently performed manually (Tawfik 2017). Development/improvement of semi-automated or automated techniques for accurate segmentation and region of interest (ROI) placement would allow for reproducible quantification of CSF flow. This would not only reduce inter-rater variability and facilitate comparison of exams.

Narrative(s)

A 9 year-old male with headaches is found to have low-lying cerebellar tonsils on CT exam suspicious for a Chiari malformation. MRI with phase contrast CSF flow sequence is ordered to assess the degree of obstruction at the foramen magnum.

Workflow Description

Both axial and sagittal phase contrast CSF sequences are obtained for quantitative and qualitative assessment respectively. An algorithm automatically segments the foramen magnum based on T1-weighted imaging. ROIs are generated in the dorsal and ventral CSF space on axial phase contrast sequence and mean velocity curves are generated. ROI placement is checked by the radiologist for quality assurance.

Inputs

 

DICOM Study

Primary Outputs

Mean systolic velocity

Tawfik AM, Elsorogy L, Abdelghaffar R, Naby AA, Elmenshawi I. Phase-Contrast MRI CSF Flow Measurements for the Diagnosis of Normal-Pressure Hydrocephalus: Observer Agreement of Velocity Versus Volume Parame