Assessment of cerebrospinal fluid hydrodynamics in patients with Chiari malformation I using highly accelerated multi-dimensional phase-contrast MRI

基亚里畸形I是由后颅窝结构改变引起的神经系统疾病。虽然这是已知的，脑脊液的流体动力学改变，在这些患者中，存在争议，其诊断价值和指导和监测治疗的潜力。一个主要的原因是相互矛盾的数据可以归因于目前可用的技术来测量脑脊液流体动力学的缺点。4D flow MRI允许对脑脊液速度进行非侵入性时间分辨、多维采集。然而，该方法在临床背景下的适用性受到采集时间长及其准确性有限的显着阻碍。目前的项目旨在通过开发一种强大且临床可行的MRI血流采集方法来解决这些缺点。这需要通过应用在多维流MRI数据中收获数据相似性的欠采样策略来提高对更宽速度谱的灵敏度并显著缩短扫描时间。在我们的研究中开发的新方法的验证过程将包括健康志愿者的数值模拟，体模测量和流量采集。其临床可行性将通过在20例基亚里畸形I患者中进行的初步研究来证实。将分析患者数据，包括流体动力学参数，如压差和脉搏波速度，并与健康志愿者进行比较。该项目是有保证的，让洞察脑脊液改变的病理生理学与基亚里畸形I型患者，并最终旨在促进新的定量成像生物标志物的发展，在这些患者的诊断工作。

Chiari Malformation I is a neurological condition caused by structural alterations of the posterior cranial fossa. While it is known that hydrodynamics of the cerebrospinal fluid are altered in these patients, controversy exists with respect to their diagnostic value and their potential to guide and monitor treatment. A main reason for the conflicting data can be attributed to the shortcomings of currently available techniques to measure cerebrospinal fluid hydrodynamics. 4D flow MRI allows for a non-invasive time-resolved, multi-dimensional acquisition of cerebrospinal fluid velocities. The methods applicability in a clinical context is however significantly hampered by long acquisition times and its limited accuracy. The current project aims to address these shortcomings by developing a robust and clinically feasible MRI flow acquisition method. This requires an increased sensitivity for a wider velocity spectrum combined with a significantly shortened scan time by applying undersampling strategies which harvest data similarity in multi-dimensional flow MRI data. The validation process of the novel methods developed in our study will include numerical simulations, phantom measurements and flow acquisitions in healthy volunteers. Its clinical feasibility will be confirmed by a pilot study in 20 patients with Chiari Malformation I. Patient data including hydrodynamic parameters such as pressure differences and pulse wave velocities will be analysed and compared to healthy volunteers. The project is warranted to allow insights into the pathophysiology of cerebrospinal fluid alterations in patients with Chiari Malformation I and ultimately aims at contributing to the development of new quantitative imaging biomarkers in the diagnostic work-up of these patients.