Evaluation of the cerebrospinal flow dynamic studies' contributions to acute-chronic disease differential diagnosis in patients with multipl sclerosis

OBJECTIVE: In this study, we purposed to determine the contributions to differential diagnosis in active-chronic term and role in the etiopathogenesis of disease by evaluating CSF flow dynamic in patients with MS, by phase contrast MRI. MATERIALS AND METHODS: To study, 16 patients with clinical and radiological diagnosis of definite MS with active plaque-enhanced on MRI, 16 patients with chronic plaque and 16 healthy people chose our environment, were included. CSF flow`s quantitatively evaluation was performed with images that were obtained by phase contrast MR angiography technique, from aqueduct level on the axial plan by two radiologists. Between 3 groups, peak velocity (cm/sec), average velocity (cm/sec), forward volume (ml), reverse volume (ml), net forward volume (ml), average flow (ml/min) values of current flowing from aqueduct and average aqueduct areas were compared. FINDINGS: The mean aqueduct area was found 3,11±1,29 mm² (1,60?5,80 mm²), mean peak velocity 4,36±1,35 cm/sec (2,92?7,74 cm/sec), mean of the average velocity 0,41±0,27 cm/sec (0,05?1,07 cm/sec), mean forward volume 0,021±0,010 ml (0,01?0,05 ml), mean reverse volume 0,013±0,007 ml (0,00?0,03 ml), mean flow 0,72±0,69 ml/min (-0,42?2,52 ml/min) in the control group. The mean aqueduct area was found 4,10±1,57 mm² (1,80?7,30 mm²), mean peak velocity 4,90±1,05 cm/sec (2,72?6,44 cm/sec), mean of the average velocity 0,50±0,30 cm/sec (0,08?1,13 cm/sec), mean forward volume 0,030±0,014 ml (0,01?0,06 ml), mean reverse volume 0,018±0,009 ml (0,01?0,04 ml), mean flow 1,11±0,78 ml/min (-0,24?2,58 ml/min) in the group of patients with active plaque. The mean aqueduct area was found 5,04±1,37 mm² (2,70?9,10 mm²), mean peak velocity 5,50±1,40 cm/sec (3,46?8,40 cm/sec), mean of the average velocity 0,36±0,20 cm/sec (0,04?0,70 cm/sec), mean forward volume 0,038±0,015 ml (0,01?0,08 ml), mean reverse volume 0,027±0,017 ml (0,01?0,08 ml), mean flow 0,99±0,76 ml/min (-0,66?2,22 ml/min) ) in the group of patients with chronic plaque. There was no significant difference between the groups in terms of mean flow. CONCLUSION: We couldn?t obtain significant results for CSF flow`s breaking down or reducing due to chronic cerebrospinal venous failure hypothesis that was reported earlier as it was related MS disease. However larger controlled studies are needed to definite the entire scope of CSF dynamics and extracranial venous hemodynamics within the framework of this hypothesis that was expressed for MS etiopathogenesis.