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

Chiari畸形I是一种由后颅窝结构改变引起的神经系统疾病。虽然已知脑脊液流体动力学在这些患者中发生改变，但关于其诊断价值及其指导和监测治疗的潜力存在争议。数据相互矛盾的一个主要原因可归因于目前可用的测量脑脊液流体动力学技术的缺陷。4D血流MRI允许非侵入性时间分辨，多维采集脑脊液速度。然而，由于采集时间长，准确性有限，该方法在临床环境中的适用性受到严重阻碍。目前的项目旨在通过开发一种强大且临床可行的MRI流采集方法来解决这些缺点。这需要提高对更宽速度谱的灵敏度，并通过应用欠采样策略来显著缩短扫描时间，该策略可以在多维流MRI数据中获取数据相似性。在我们的研究中开发的新方法的验证过程将包括数值模拟，模拟测量和健康志愿者的流量采集。其临床可行性将通过对20例i型Chiari畸形患者的试点研究来证实。患者数据包括压差和脉搏波速度等流体动力学参数将被分析并与健康志愿者进行比较。该项目旨在深入了解I型Chiari畸形患者脑脊液改变的病理生理学，最终旨在为这些患者的诊断工作提供新的定量成像生物标志物。

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.