Characterization of Cyclic CSF Flow in the Foramen Magnum and Upper Cervical Spinal Canal with MR Flow Imaging and Computational Fluid Dynamics
Characterization of Cyclic CSF Flow in the Foramen Magnum and Upper Cervical Spinal Canal with MR Flow Imaging and Computational Fluid Dynamics
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DOI：
10.3174/ajnr.a1995
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发表时间：
2010-06-01
影响因子：
3.5
通讯作者：
Haughton, V.
中科院分区：
文献类型：
--
作者：
Hentschel, S.;Mardal, K. -A.;Haughton, V.
在健康受试者和Chiari I型畸形患者的MR图像中，脑脊液流量显示出复杂的模式。根据主流观点，异常的脑脊液流量振荡会导致脊髓空洞和其他影响一些Chiari I型畸形患者的临床表现。在本文中，我们回顾了脑脊液流动的PC MR文献，收集了已发表的与脑脊液流动相关的CFD研究，并进行了流动模拟。PC MR创建电影和静止图像的脑脊液流动和流速的测量。CFD是一种用于计算液体系统中流量和压力的技术，它模拟了SAS特定几何形状或解剖结构以及特定流量下的CSF流动模式。已发表的PC MR研究显示，与健康受试者相比，Chiari I患者的脑脊液峰值速度更高，血流模式更复杂，同步双向血流是病理性血流的特征标志之一。在高分辨率MR图像创建的SAS数学模型中，CFD显示了与患者PC MR相似的复杂脑脊液流动模式。CFD显示上椎管内不同水平的压力和流量模式不同，并且在Chiari患者和健康志愿者之间存在差异。在包含弹性和运动的模型中，CFD在SAS中显示CSF压力波。迄今为止，PC - MR和CFD研究表明，Chiari i型患者的脑脊液流量和压力模式有显著改变。脑脊液流量具有复杂的非层流空间和时间变化以及相关的压力波和压力梯度。在PC MR的辅助下，对脑脊液血流进行额外的模拟，将有助于更好地区分导致脊髓空洞、头痛和Chiari I型畸形的其他临床表现的病理性血流异常。
CSF flow has been shown to exhibit complex patterns in MR images in both healthy subjects and in patients with Chiari I. Abnormal CSF flow oscillations, according to prevailing opinion, cause syringomyelia and other clinical manifestations that affect some patients with the Chiari I malformation. For this article, we reviewed the literature on PC MR of CSF flow, collected the published CFD studies relevant to CSF flow, and performed flow simulations. PC MR creates cine and still images of CSF flow and measurements of flow velocities. CFD, a technique used to compute flow and pressure in liquid systems, simulates the CSF flow patterns that occur in a specific geometry or anatomy of the SAS and a specific volume of flow. Published PC MR studies show greater peak CSF velocities and more complex flow patterns in patients with Chiari I than in healthy subjects, with synchronous bidirectional flow one of the characteristic markers of pathologic flow. In mathematic models of the SAS created from high-resolution MR images, CFD displays complex CSF flow patterns similar to those shown in PC MR in patients. CFD shows that the pressure and flow patterns vary from level to level in the upper spinal canal and differ between patients with Chiari and healthy volunteers. In models in which elasticity and motion are incorporated, CFD displays CSF pressure waves in the SAS. PC MR and CFD studies to date demonstrate significant alterations of CSF flow and pressure patterns in patients with Chiari I. CSF flow has nonlaminar complex spatial and temporal variations and associated pressure waves and pressure gradients. Additional simulations of CSF flow supplemented by PC MR will lead to better measures for distinguishing pathologic flow abnormalities that cause syringomyelia, headaches, and other clinical manifestations in Chiari I malformations.