E. Hofmann et al., Phase-contrast MR imaging of the cervical CSF and spinal cord: Volumetric motion analysis in patients with Chiari I malformation, AM J NEUROR, 21(1), 2000, pp. 151-158
Citations number
31
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Neurosciences & Behavoir
BACKGROUND AND PURPOSE: Most previous MR studies of the dynamics of Chiari
I malformation have been confined to sagittal images and operator-dependent
measurement points in the midline, To obtain a deeper insight into the pat
hophysiology of the Chiari I malformation, we performed a prospective study
using axial slices at the level of C2 to analyze volumetric motion data of
the spinal cord and CSF over the whole cross-sectional area.
METHODS: Eighteen patients with Chiari I malformation and 18 healthy contro
l subjects underwent cardiac-gated phase-contrast imaging, Cross-sectional
area measurements and volumetric flow/motion data calculations were made fo
r the following compartments: the entire intradural space, the spinal cord,
and the anterior and posterior subarachnoid space.
RESULTS: The most striking feature was an increased early systolic caudal a
nd diastolic cranial motion of the spinal cord in the patients. CSF pulsati
ons in the anterior subarachnoid space were unchanged at systole but showed
an impaired diastolic upward flow. In the posterior compartment, the CSF s
ystole was slightly shortened, with an impairment of diastolic upward flow.
Fourteen of the 18 patients had associated syringeal cavities, This subgro
up showed an increased systolic downward displacement of the cord as compar
ed with patients without a syrinx.
CONCLUSION: Obstruction of the foramen magnum in patients with Chiari I mal
formation causes an abrupt systolic downward displacement of the spinal cor
d and impairs the recoil of CSF during diastole.