Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging

Object. The purpose of this prospective study was to evaluate aqueductal ce rebrospinal fluid (CSF) flow after endoscopic aqueductoplasty. In all patie nts, preoperative magnetic resonance (MR) imaging revealed hydrocephalus ca used by aqueductal stenosis and lack of aqueductal CSF flow. Methods. In 14 healthy volunteers and in eight patients with aqueductal ste nosis who had undergone endoscopic aqueductoplasty, aqueductal CSF flow was investigated using cine cardiac-gated phase-contrast MR imaging. For quali tative evaluation of CSF flow, the authors used an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed -loop cine format. Quantitative through-plane measurements were performed i n the axial plane perpendicular to the aqueduct. Evaluation revealed no sig nificant difference in aqueductal CSF flow between healthy volunteers and p atients with regard to temporal parameters, CSF peak and mean velocities, m ean flow, and stroke volume. All restored aqueducts have remained patent 7 to 31 months after surgery. Conclusions. Aqueductal CSF flow after endoscopic aqueductoplasty is simila r to aqueductal CSF flow in healthy volunteers. The data indicate that endo scopic aqueductoplasty seems to restore physiological aqueductal CSF flow.