Cine cerebrospinal fluid imaging in multiple sclerosis

Christopher Magnano, Claudiu Schirda, Bianca Weinstock-Guttman, David S. Wack, Eric Lindzen, David Hojnacki, Niels Bergsland, Cheryl Kennedy, Pavel Belov, Michael G. Dwyer, Guy U. Poloni, Clive B. Beggs, Robert Zivadinov

Research output: Contribution to journalArticlepeer-review


Purpose: To investigate cerebrospinal fluid (CSF) dynamics in the aqueduct of Sylvius in multiple sclerosis (MS) patients and healthy controls (HC) using cine phase contrast imaging. Materials and Methods: In all, 67 MS patients (48 relapsing-remitting [RR] and 19 secondary-progressive [SP]), nine patients with clinically isolated syndrome (CIS), and 35 age- and sex-matched HC were examined. CSF flow and velocity measures were quantified using a semiautomated method and compared with clinical and magnetic resonance imaging (MRI) disease outcomes. Results: Significantly decreased CSF net flow was detected in MS patients compared to HC (-3.7 vs. -7.1 μL/beat, P = 0.005). There was a trend for increased net positive flow between SP, RR, and CIS patients. Altered CSF flow and velocity measures were associated with more severe T1 and T2 lesion volumes, lateral and fourth ventricular volumes, and third ventricular width in MS and CIS patients (P <0.01 for all). In CIS patients, conversion to clinically definite MS in the following year was related to decreased CSF net flow (P = 0.007). There was a trend between increased annual relapse rate and altered CSF flow/velocity measures in RRMS patients (P <0.05). Conclusion: CSF flow dynamics are altered in MS patients. More severe clinical and MRI outcomes in RRMS and CIS patients relate to altered CSF flow and velocity measures.

Original languageEnglish
Pages (from-to)825-834
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Issue number4
Publication statusPublished - Oct 2012


  • aqueduct of Sylvius
  • cerebrospinal fluid
  • MRI
  • multiple sclerosis
  • phase contrast imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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