Annals of Biomedical Engineering

, Volume 44, Issue 5, pp 1524–1537 | Cite as

Inter-operator Reliability of Magnetic Resonance Image-Based Computational Fluid Dynamics Prediction of Cerebrospinal Fluid Motion in the Cervical Spine

  • Bryn A. MartinEmail author
  • Theresia I. Yiallourou
  • Soroush Heidari Pahlavian
  • Suraj Thyagaraj
  • Alexander C. Bunck
  • Francis Loth
  • Daniel B. Sheffer
  • Jan Robert Kröger
  • Nikolaos Stergiopulos


For the first time, inter-operator dependence of MRI based computational fluid dynamics (CFD) modeling of cerebrospinal fluid (CSF) in the cervical spinal subarachnoid space (SSS) is evaluated. In vivo MRI flow measurements and anatomy MRI images were obtained at the cervico-medullary junction of a healthy subject and a Chiari I malformation patient. 3D anatomies of the SSS were reconstructed by manual segmentation by four independent operators for both cases. CFD results were compared at nine axial locations along the SSS in terms of hydrodynamic and geometric parameters. Intraclass correlation (ICC) assessed the inter-operator agreement for each parameter over the axial locations and coefficient of variance (CV) compared the percentage of variance for each parameter between the operators. Greater operator dependence was found for the patient (0.19 < ICC < 0.99) near the craniovertebral junction compared to the healthy subject (ICC > 0.78). For the healthy subject, hydraulic diameter and Womersley number had the least variance (CV = ~2%). For the patient, peak diastolic velocity and Reynolds number had the smallest variance (CV = ~3%). These results show a high degree of inter-operator reliability for MRI-based CFD simulations of CSF flow in the cervical spine for healthy subjects and a lower degree of reliability for patients with Type I Chiari malformation.


Cerebrospinal fluid (CSF) Computational fluid dynamics (CFD) Magnetic resonance imaging (MRI) Chiari malformation Neurohydrodynamics Subarachnoid space 



This work was supported by the Swiss National Foundation Grant Nos. 205321_132695/1 and IZK0Z2_152766, NIH R-15 Grant 492 1R15NS071455-01, American Syringomyelia and Chiari Alliance Project and Chiari and Syringomyelia Patient Education Foundation.

Conflict of Interest



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Copyright information

© Biomedical Engineering Society 2015

Authors and Affiliations

  • Bryn A. Martin
    • 1
    Email author
  • Theresia I. Yiallourou
    • 2
  • Soroush Heidari Pahlavian
    • 3
  • Suraj Thyagaraj
    • 3
  • Alexander C. Bunck
    • 4
    • 5
  • Francis Loth
    • 3
  • Daniel B. Sheffer
    • 6
  • Jan Robert Kröger
    • 4
    • 5
  • Nikolaos Stergiopulos
    • 2
  1. 1.Neurophysiological Imaging and Modeling Laboratory, Department of Biological EngineeringThe University of IdahoMoscowUSA
  2. 2.Laboratory of Hemodynamics and Cardiovascular TechnologyÉcole Polytechnique Fédérale de LausanneLausanneSwitzerland
  3. 3.Department of Mechanical Engineering, Conquer Chiari Research CenterThe University of AkronAkronUSA
  4. 4.Department of RadiologyUniversity Hospital of CologneCologneGermany
  5. 5.Department of Clinical RadiologyUniversity of MuensterMünsterGermany
  6. 6.Department of Biomedical EngineeringThe University of AkronAkronUSA

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