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Accuracy of 4D Flow Measurement of Cerebrospinal Fluid Dynamics in the Cervical Spine: An In Vitro Verification Against Numerical Simulation

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Abstract

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.

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Abbreviations

CSF:

Cerebrospinal fluid

CNS:

Central nervous system

SAS:

Subarachnoid space

PCMRI:

Phase-contrast magnetic resonance imaging

CFD:

Computational fluid dynamics

FM:

Foramen magnum

TR:

Repetition time

TE:

Echo time

VENC:

Encoding velocity

VNR:

Velocity to noise ratio

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Acknowledgments

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.

Author information

Authors and Affiliations

  1. Conquer Chiari Research Center, The University of Akron, Akron, OH, USA

    Soroush Heidari Pahlavian, Suraj Thyagaraj & Francis Loth

  2. Department of Mechanical Engineering, The University of Akron, Akron, OH, USA

    Soroush Heidari Pahlavian, Suraj Thyagaraj & Francis Loth

  3. Department of Radiology, University Hospital of Cologne, Cologne, Germany

    Alexander C. Bunck, Daniel Giese & Dennis M. Hedderich

  4. Department of Radiology, University Hospital of Muenster, Muenster, Germany

    Alexander C. Bunck & Jan Robert Kröger

  5. Department of Biological Engineering, The University of Idaho, 875 Perimeter Drive MS 0904, Moscow, ID, 83844-0904, USA

    Bryn A. Martin

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  1. Soroush Heidari Pahlavian
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Correspondence to Bryn A. Martin.

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Associate Editor Agata A. Exner oversaw the review of this article.

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Heidari Pahlavian, S., Bunck, A.C., Thyagaraj, S. et al. Accuracy of 4D Flow Measurement of Cerebrospinal Fluid Dynamics in the Cervical Spine: An In Vitro Verification Against Numerical Simulation. Ann Biomed Eng 44, 3202–3214 (2016). https://doi.org/10.1007/s10439-016-1602-x

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