Contribution of T2A 3d-space sequence to diagnosis in MRİ CSF studies

Aim: CSF flow analysis method helps diagnosis in evaluating many diseases affecting the central nervous system. This method, which is frequently used in phase contrast cine MRI technique, can give incomplete or erroneous results due to technical inadequacy or lack of experience. In this study, we evaluated the relationship between T2A 3D-SPACE sequence and phase contrast cine MRI images by classifying the signal void at the 4th ventricle. We aimed to show that there is a qualitative relationship between the quantitatively calculated CSF flow rate and CSF flow volume. Material and Methods: Between 2018-2020, upon the request of Düzce University Hospital clinicians, all CSF flow MRI examinations were evaluated with the 3 Tesla MRI device in our department. The T2A 3D-SPACE sequence was included in all exams. In the T2A 3D-SPACE sequence, the amount of signal void secondary to the CSF flow in the 4th ventricle was classified into 4 grades. Grade 0; No signal void in aquaductus silvii and 4th ventricle. Grade 1; thin signal void in distal of aquaductus silvii and proximal 4th ventricle. Grade 2; Linear signal void in the anterior of the 4. ventricle extending distal to the ventricle but not filling the median dorsal recess. Grade 3; The signal void filling the 4. ventricle. Results: There was a statistically significant difference was found in different grades and peak velocity averages. There was a statistically significant difference was found in different grades and flow volume averages. It was seen that the mean the size of the area measured in the 4th ventricle in the patient group defined as Grade 0 was significantly different than the other grades (p <0.001). It was observed that the mean ages of the patients with different grades were similar (p = 0.144). In the correlation analysis; There was a positive and moderate significant correlation between and Flow, a positive moderate correlation between Grade and Flow, a positive and significant correlation between Grade and Peak, and a positive and significant correlation between Flow and Peak. Conclusion: In the T2A 3D-SPACE sequence, it was found that the amount of signal void in the 4th ventricle was correlated with the peak systolic velocity and flow volume measured quantitatively in the CSF flow MRI, and it was concluded that it was helpful in diagnostic evaluation. Therefore, we think that T2A 3D-SPACE sequence should be added in CSF flow MRI examinations.