Dynamics of lateral ventricle and cerebrospinal fluid in normal and hydrocephalic brains

Purpose: To develop quantitative MRI techniques to measure, model, and visualize cerebrospinal fluid (CSF) hydrodynamics in normal subjects and hydrocephalic patients. Materials and Methods: Velocity information was obtained using time-resolved (CINE) phase-contrast imaging of different brain regions. A technique was developed to measure the change of lateral ventricle (LV) size. The temporal relationships between the LV size change, CSF movement, and blood flow could then be established. The data were incorporated into a first-principle CSF hydrodynamic model. The model was then used to generate specific predictions about CSF pressure relationships. To better-visualize the CSF flow, a color-coding technique based on linear transformations was developed that represents the magnitude and direction of the velocity in a single cinematic view. Results: The LV volume change of the eight normal subjects was 0.901 +/- 0.406%. Counterintuitively, the LV decreases as the choroid plexus expands, so that they act together to produce the CSF oscillatory flow. The amount of oscillatory flow volume is 21.7 +/- 10.6% of the volume change of the LV from its maximum to its minimum. Conclusion: The quantification and visualization techniques, together with the mathematical model, provide a unique approach to understanding CSF flow dynamics.