Advanced cerebrospinal fluid flow MRI findings of aqueductal stenosis caused by web

Background The aqueductal web (AW) is one of the causes of aqueductus stenosis (AS). Recent advances in Magnetic resonance (MR) imaging have enabled us to better reveal the cerebrospinal fluid (CSF) flow dynamics and aqueductal anatomy. Purpose The aim of this study is to evaluate the CSF flow dynam...

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Bibliographic Details
Published in:Journal of clinical ultrasound 2024-02, Vol.52 (2), p.201-207
Main Authors: Yilmaz, Temel Fatih, Sari, Lutfullah, Toprak, Huseyin
Format: Article
Language:English
Subjects:
Adult
Aged
aqueductal stenosis
Cerebral Aqueduct - abnormalities
Cerebral Aqueduct - diagnostic imaging
Cerebral Aqueduct - pathology
Cerebrospinal fluid
CSF flow
Female
Fluid flow
Genetic Diseases, X-Linked
Humans
Hydrocephalus - diagnostic imaging
Localization
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medical imaging
MRI
Phase contrast
Stenosis
web
Webs
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Summary:Background The aqueductal web (AW) is one of the causes of aqueductus stenosis (AS). Recent advances in Magnetic resonance (MR) imaging have enabled us to better reveal the cerebrospinal fluid (CSF) flow dynamics and aqueductal anatomy. Purpose The aim of this study is to evaluate the CSF flow dynamics of patients with AW with phase contrast Magnetic resonance imaging (MRI) and compare them with the imaging findings. Materials and Methods We evaluated 23 patients under 65‐year‐old age. On constructive interference in steady‐state (T2 CISS) images, the width of prepontine cistern (PPC) and the width of Sylvian aqueduct (SA) were measured. Localization and number of webs were evaluated. The existence of flow at the aqueduct and the presence of spontaneous third ventriculostomy (STV) were evaluated on sagittal Sampling Perfection with Application optimized Contrast (SPACE) sequences. Results Of the 23 patients included in the study, 11 were male and 12 were female. The mean age was 34.02 (0.5–64). A total of 31 AWs were detected in 23 patients. Six of 23 patients (26.1%) had STV and 17 of those not. Four of 23 patients (17.4%) had aqueductal flow on SPACE sequences. The PPC distance was significantly wider in patients with STV (median: 6.7–4.5, interquartile range (IQR): 1.35, p = 0.004). In the cases where artifact secondary to flow is observed in SPACE sequences in aqueduct, the Evan index (EI) was significantly lower (median: 0.2955–0.3900, IQR: 0.03–0.14, p 
ISSN:0091-2751
1097-0096
DOI:10.1002/jcu.23606