Influence of respiration on cerebrospinal fluid movement using magnetic resonance spin labeling.

BACKGROUND: Magnetic resonance imaging (MRI) cardiac gated phase contrast (PC) cine techniques have non-invasively shown the effect of the cardiac pulse on cerebrospinal fluid (CSF) movement. Echo planar imaging (EPI) has shown CSF movement as influenced by both cardiac pulsation and respiration. Previously, it has not been possible to visualize CSF movement in response to respiration non-invasively. The present study was undertaken to do so. METHODS: The effect of respiration on CSF movement was investigated using a non-contrast time-spatial labeling inversion pulse (Time-SLIP) with balanced steady-state free precession (bSSFP) readout. CSF movement was observed in the intracranial compartment in response to respirations in ten normal volunteers. To elucidate the respiration effect, the acquisition was triggered at the beginning of deep inhalation, deep exhalation and breath holding. RESULTS: By employing this respiration-induced spin labeling bSSFP cine method, we were able to visualize CSF movement induced by respiratory excursions. CSF moved cephalad (16.4 ± 7.7 mm) during deep inhalation and caudad (11.6 ± 3.0 mm) during deep exhalation in the prepontine cisternal area. Small but rapid cephalad (3.0 ± 0.4 mm) and caudad (3.0 ± 0.5 mm) movement was observed in the same region during breath holding and is thought to reflect cardiac pulsations. CONCLUSIONS: The Time-SLIP bSSFP cine technique allows for non-invasive visualization of CSF movement associated with respiration to a degree not previously reported.

Visualization of cerebrospinal fluid movement with spin labeling at MR imaging: preliminary results in normal and pathophysiologic conditions.

Institutional review board approval and informed consent were obtained for this study. This study was HIPAA compliant. The purpose of this study was to visualize the movement of cerebrospinal fluid (CSF) noninvasively by using an unenhanced magnetic resonance imaging technique. A time-spatial labeling inversion pulse (SLIP) technique was applied to label, or tag, CSF in a region of interest. The tagged CSF was clearly visualized at inversion times of 1500-4500 msec after pulse labeling in both intracranial and intraspinal compartments. Noninvasive visualization of CSF movement, including bulk and turbulent flow, in normal (n = 7) and altered (n = 2) physiologic conditions was possible by using the unenhanced time-SLIP technique.