Accuracy of 4D Flow Measurement of Cerebrospinal Fluid Dynamics in the Cervical Spine: An In Vitro Verification Against Numerical Simulation
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Abnormal alterations in cerebrospinal fluid (CSF) flow are thought to play an important role in pathophysiology of various craniospinal disorders such as hydrocephalus and Chiari malformation. Three directional phase contrast MRI (4D Flow) has been proposed as one method for quantification of the CSF dynamics in healthy and disease states, but prior to further implementation of this technique, its accuracy in measuring CSF velocity magnitude and distribution must be evaluated. In this study, an MR-compatible experimental platform was developed based on an anatomically detailed 3D printed model of the cervical subarachnoid space and subject specific flow boundary conditions. Accuracy of 4D Flow measurements was assessed by comparison of CSF velocities obtained within the in vitro model with the numerically predicted velocities calculated from a spatially averaged computational fluid dynamics (CFD) model based on the same geometry and flow boundary conditions. Good agreement was observed between CFD and 4D Flow in terms of spatial distribution and peak magnitude of through-plane velocities with an average difference of 7.5 and 10.6% for peak systolic and diastolic velocities, respectively. Regression analysis showed lower accuracy of 4D Flow measurement at the timeframes corresponding to low CSF flow rate and poor correlation between CFD and 4D Flow in-plane velocities.
KeywordsMagnetic resonance imaging 4D Flow measurement Cerebrospinal fluid Computational fluid dynamics Phantom experiment
Central nervous system
Phase-contrast magnetic resonance imaging
Computational fluid dynamics
Velocity to noise ratio
Authors would like to appreciate Conquer Chiari and American Syringomyelia Alliance Project for the support of this work. Authors would also like to acknowledge Dr. Jae-Won Choi and Dr. Morteza Vatani for the helpful discussions and assistance in the rapid-prototyping of the phantom model.
Conflict of interest
Authors have no conflict of interests.
- 5.Bunck, A. C., J. R. Kroeger, A. Juettner, A. Brentrup, B. Fiedler, G. R. Crelier, B. A. Martin, W. Heindel, D. Maintz, W. Schwindt, and T. Niederstadt. Magnetic resonance 4D flow analysis of cerebrospinal fluid dynamics in Chiari I malformation with and without syringomyelia. Eur. Radiol. 22:1860–1870, 2012.CrossRefPubMedGoogle Scholar
- 6.Bunck, A. C., J. R. Kroger, A. Juttner, A. Brentrup, B. Fiedler, F. Schaarschmidt, G. R. Crelier, W. Schwindt, W. Heindel, T. Niederstadt, and D. Maintz. Magnetic resonance 4D flow characteristics of cerebrospinal fluid at the craniocervical junction and the cervical spinal canal. Eur. Radiol. 21:1788–1796, 2011.CrossRefPubMedGoogle Scholar
- 8.Canstein, C., P. Cachot, A. Faust, A. F. Stalder, J. Bock, A. Frydrychowicz, J. Kuffer, J. Hennig, and M. Markl. 3D MR flow analysis in realistic rapid-prototyping model systems of the thoracic aorta: comparison with in vivo data and computational fluid dynamics in identical vessel geometries. Magn. Reson. Med. 59:535–546, 2008.CrossRefPubMedGoogle Scholar
- 13.Heidari Pahlavian, S., A. C. Bunck, F. Loth, R. Shane Tubbs, T. Yiallourou, J. R. Kroeger, W. Heindel, and B. A. Martin. Characterization of the discrepancies between four-dimensional phase-contrast magnetic resonance imaging and in silico simulations of cerebrospinal fluid dynamics. J Biomech Eng 137:051002, 2015.CrossRefPubMedGoogle Scholar
- 17.Iliff, J. J., M. Wang, Y. Liao, B. A. Plogg, W. Peng, G. A. Gundersen, H. Benveniste, G. E. Vates, R. Deane, S. A. Goldman, E. A. Nagelhus, and M. Nedergaard. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid beta. Sci Transl Med 4:147ra111, 2012.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Jacobs, P. F., D. T. Reid, and Computer and A. S. A. o. SME. Rapid Prototyping & Manufacturing: Fundamentals of Stereolithography. Dearborn: Society of Manufacturing Engineers, 1992.Google Scholar
- 22.Lagana, M. M., A. Chaudhary, D. Balagurunathan, D. Utriainen, P. Kokeny, W. Feng, P. Cecconi, D. Hubbard, and E. M. Haacke. Cerebrospinal fluid flow dynamics in multiple sclerosis patients through phase contrast magnetic resonance imaging. Curr. Neurovasc. Res. 11:349–358, 2014.CrossRefPubMedGoogle Scholar
- 25.Martin, B. A., T. I. Yiallourou, S. H. Pahlavian, S. Thyagaraj, A. C. Bunck, F. Loth, D. B. Sheffer, J. R. Kroger, and N. Stergiopulos. Inter-operator reliability of magnetic resonance image-based computational fluid dynamics prediction of cerebrospinal fluid motion in the cervical spine. Ann. Biomed. Eng. 43:1–14, 2015.CrossRefGoogle Scholar
- 27.Nelissen, R. M. Fluid Mechanics of Intrathecal Drug Delivery, Doctoral Thesis. EPFL, Lausanne, Switzerland: Citeseer, 2008.Google Scholar
- 36.Yiallourou, T. I., J. R. Kroger, N. Stergiopulos, D. Maintz, A. C. Bunck, and B. A. Martin. Comparison of 4D phase-contrast MRI flow measurements to computational fluid dynamics simulations of cerebrospinal fluid motion in the cervical spine. PLoS ONE 7:e52284, 2012.CrossRefPubMedPubMedCentralGoogle Scholar