Magnetic Resonance Imaging Study of Cerebrospinal Fluid

Magnetic Resonance Imaging Study of cerebrospinal FluidMagnetic Resonance Imaging Study of Cerebrospinal Fluid Dynamics in Congenital Brain AnomaliesProtocol of Thesis for Partial Fulfillment of Master Degree in RadiodiagnosisByEman Mahmoud Elsayed SobhM.B.B.ChRadiodiagnosis Resident Ministry of healthSupervisorsProf. Dr. Amany Ezzat Mohammed MousaProfessor of RadiodiagnosisFaculty of MedicineMansoura UniversityDr. Mahmoud Abd Ellatif MohammedAssistant Professor of RadiodiagnosisFaculty of MedicineMansoura University2017IntroductionCongenital brain anomalies are deviate developments of the brain that happen during intrauterine life and they are rare among the inhering anomalies of various organ systems. These anomalies of the central nervous system cause approximately 25% of perinatal deaths and account for round 33% of all major anomalies diagnosed at or after birth. The etiology of congenital brain anomalies is poorly understood, albeit some clinical and experimental evidence indicates that a variety of factors, including genetic (chromosome abnormality), environmental (ionizing radiation, toxic agents), infection (rubella and cytomegalovirus), and nutrition (hypervitaminosis A) might play some roles(Chen Zimmerman, 2000).It is important to diagnose these conditions as early as thinkable due to its far reaching neurological deficit and detrimental outcome. Most of the congenital brain anomalies apprise be reliably diagnosed by neuro vision (computed tomography or magnetized resonance imaging) of the brain. Radiologist and treating physician should be aware of various specific imaging appearances and unique signs of these anomalies to avoid delay in diagnosis and thereby further treatment (Singh, Srivastav, Singhania, Devi, 2014).Imaging techniques may be underutilized when clinicians are unaware of the technique or dont recognize its potential. During the last three decades, unravel-sensitive magnetic resonance imaging (MRI) techniques have been in creasingly applied to quantitatively and qualitatively assess cerebrospinal fluid (CSF) flow dynamics in congenital brain disorders. CSF flowmetry is an extremely worth(predicate) tool because it is rapid, sensitive, non-invasive, easily performed and provides critical information in preoperative assessment as well as post-operative follow up of these patients. It is also effective in treatment planning (Yildiz, Yazici, Hakyemez, Erdogan, Parlak, 2006 Zhang Li, 2012).Phase contrast MRI is one the magnetic resonance angiography techniques that have been modified to study the CSF hydrodynamics. The normal and abnormal CSF hydrodynamics can be assessed quantitatively by measuring the peak velocity of CSF in the aqueduct using two-dimensional phase-contrast MRI which demonstrates mechanical coupling between cerebral line of products and CSF flow during the cardiac cycle. The normal physiologic motion of CSF is pulsatile which synchronizes with the cardiac cycle. Quantitative analysi s of CSF flow in pathways such as aqueduct that is tubular and relatively unremitting in diameter is desirable because the resulting laminar flow can be measured accurately by phase-contrast MRI. Qualitative assessment provides visual appreciation of the CSF flow through the aqueduct and basal cisterns. (Giiang, Chen, Chen, Huang, Chung, 2000).Aim of WorkThe aim of this work is to assess the CSF flow dynamics in different congenital brain anomalies using phase-contrast magnetic resonance imaging (PC MRI).PatientsSite of the study Mansoura University Hospital, Radiodiagnosis Department, MRI unitSample size 30 patientsDuration within 1 yearInclusion CriteriaPatients with congenital brain anomalies diagnosed clinically or radiologicallyExclusion criteriaPatients / Guardians refusing the procedurePatients have contraindications to MRI studiesPatients with associated known arrhythmiasMethodologyAll patients will be subjected toFull clinical examRadiological investigations (MRI includi ng phase contrast study of CSF flow dynamics)Electrocardiograph (ECG)Informed consent will be obtained from all patients after full explanation of the benefits and risks of the procedure. any unexpected risks appear during the course of the research will be cleared to the participants and the ethical committee on timeAny patients will be set in the hospital if any complications occur to them related to the techniquePrivacy and confidentiality will be maintained to all patients.ReferencesChen, C.-Y., Zimmerman, R. A. (2000). Congenital brain anomalies Neuroimaging (pp. 491-530) Springer.Giiang, L.-H., Chen, C.-Y., Chen, M.-Y., Huang, T.-Y., Chung, W. (2000). Normal and abnormal cerebrospinal fluid dynamics evaluated by optimized cine phase-contrast MR imaging. Chin J Radiol, 25, 191-195.Singh, T. G., Srivastav, V., Singhania, P., Devi, S. M. (2014). Congenital brain anomalies Neuroimaging findings. Journal of Dr. NTR University of Health Sciences, 3(2), 77.Yildiz, H., Yazici, Z., Hakyemez, B., Erdogan, C., Parlak, M. (2006). Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging. Neuroradiology, 48(9), 595-605. doi10.1007/s00234-006-0098-8Zhang, B., Li, S. B. (2012). Cine-PC MR in assessment of cerebrospinal fluid velocity in the aqueduct of the midbrain correlated with intracranial pressureinitial study. Med Hypotheses, 78(2), 227-230. doi10.1016/j.mehy.2011.10.031