Difference between revisions of "What is the relative distribution of spinal subarachnoid space volumetric compliance in healthy subjects?"

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==The problem==
 
==The problem==
Craniospinal compliance has been thought to be an important indicator of craniospinal health.  However, a non-invasive technique for assessment of craniospinal compliance is not available.  The proposed pilot study aims to investigate the feasibility of a novel non-invasive 4D MR flow quantification technique5 to measure the relative distribution of volumetric compliance of the spinal subarachnoid space (Figure 1).  
+
Craniospinal compliance has been thought to be an important indicator of craniospinal health.  However, a non-invasive technique for assessment of craniospinal compliance is not available.  The proposed pilot study aims to investigate the feasibility of a novel non-invasive 4D MR flow quantification technique (Santini, Wetzel et al. 2009) to measure the relative distribution of volumetric compliance of the spinal subarachnoid space (SSS) (Figure 1).  
 
+
 
The relative distribution of spinal canal compliance can be measured by integration of the velocity over a manually selected cross-sectional region of the spinal canal for an entire cardiac cycle as detailed by Martin et al. 3,4.  If the entire 4D flow field in the spinal subarachnoid space is known5, then it is possible to obtain the relative distribution of compliance along the entire spinal canal which may be indicative of craniospinal health.
+
The volumetric compensation of SSS to the cerebrospinal fluid pulsations (CSF) can be measured by determining the instantaneous difference of flow into and out of a SSS control volume. If the entire flow field in the SSS is known (Santini, Wetzel et al. 2009), then it is possible to obtain the relative distribution of compliance along the spinal canal.    
  
 
==Hypothesis and research objectives==
 
==Hypothesis and research objectives==
We hypothesize that in healthy persons most of the volumetric compensation of the CSF pulsation takes place in the cervical subarachnoid space.  The goal of this research is thus to validate the feasibility of a novel 4D MR flow protocol for measurement of the distribution of spinal canal compliance in a healthy person.   
+
We hypothesize that in healthy persons most of the volumetric compensation of the CSF pulsation takes place in the cervical subarachnoid space.  The goal of this research is thus to measure the distribution of spinal SAS compliance in healthy subjects using two novel MR protocols.   
  
 
==Methods and study outline==
 
==Methods and study outline==
;A. in vivo MR measurements.  
+
;A. In vivo MR measurements.  
Our approach is to obtain 4D CSF flow velocity measurements on a single healthy subject using the protocol developed by Santini et al.5.  
+
 
 +
Our approach is to obtain CSF flow velocity measurements on three age-matched healthy subjects using the following protocols.
 +
 
 +
1. For SA1b, high-resolution balanced-steady-state free procession cine (bSSFP) images gated to the cardiac cycle will be obtained from a healthy subject at the various vertebrae levels (i.e. C2, C8, and T4 as in Figure 10).  These cine loops will be acquired for at least 25 frames over the cardiac cycle and be used to investigate the distribution of spinal SAS compliance.
 +
 
 +
2. For SA1c, and SA1d, flow measurements in cranial (c) and spinal (d) SAS will be conducted using the protocol developed by Santini et al. (Figure 10) (Santini, Wetzel et al. 2009).  Subjects will be asked to lie in the supine position in the scanner bed with a standard 12-channel head coil and neck coil (Siemens Medical Solutions).  CSF flow measurements will be performed in healthy volunteers in the spinal SAS (C2 to lumbar if possible), hindbrain, and ventricles with the following imaging parameters: venc = 10 cm/s, TE = 6 ms, TR = 12 ms, flip angle = 70°. Total scan time for each subject will be approximately 20 min.
 +
 
 +
3. Repeatability will be examined by obtaining measurements in 1) and 2) on the same subject three times.
 +
 
 +
;B. Processing of MR data. 
 +
The relative distribution of spinal canal compliance will be calculated based on the CSF flow velocity measurements
 +
 
 +
1. CSF flow waveforms in the spinal SAS will be obtained from the recorded velocity for each pixel from pcMR images.  Pixel velocity will be integrated over a manually selected cross-sectional ROI for an entire cardiac cycle as detailed by Kalata (Kalata 2002).  The basic equation for this process is given by , where Apixel is the area of one MRI pixel, Vpixel is the velocity for the corresponding pixel, and Q(t) is the summation of the flow for each pixel of interest.
  
;B. processing of MR data.   
+
2. Using a technique similar to Martin et al. (Kalata 2002; Martin, Kalata et al. 2005), the volume change of a section of the spinal SAS will be computed as followsA control volume will be defined by two parallel planes that are each orthogonal to CSF flow separated by a distance (L)The volume flux of the ROI will be computed by integration of the flow difference into and out-of the ROI.
The relative distribution of spinal canal compliance will be calculated based on the CSF flow velocity measurements using a technique similar to Martin et al.4These measurements will be compared to those already available in the literature1,2.
+
 
 +
3. Thus, If the entire 4D flow field in the SAS is known (Santini, Wetzel et al. 2009), then it is possible to obtain the relative distribution of compliance along the entire spinal canal using the provided techniques.    
  
 
==Expected results and potential impact==
 
==Expected results and potential impact==
The proposed work will determine if the non-invasive MR protocol is capable of measuring the distribution of compliance in the spinal canal in a single healthy volunteer.  If proven efficacious, the test could be further explored with healthy volunteers and patients, and has the potential to provide a clinically useful tool for assessment of relative distribution in craniospinal compliance.
+
The proposed work will determine if the non-invasive MR protocol is capable of measuring the distribution of compliance in the spinal canal in healthy volunteers.  If proven efficacious, the test could be further explored with patients, and has the potential to provide a clinically useful tool for assessment of relative distribution in craniospinal compliance.
  
 
==Preliminary results==
 
==Preliminary results==
Line 28: Line 41:
  
 
==References==
 
==References==
1. Alperin N, Sivaramakrishnan A, Lichtor T: Magnetic resonance imaging-based measurements of cerebrospinal fluid and blood flow as indicators of intracranial compliance in patients with Chiari malformation. J Neurosurg 103:46-52, 2005
+
Kalata, W. (2002). "Numerical simulation of cerebrospinal fluid motion within the spinal canal." Masters Thesis Chicago, University of Illinois at Chicago.
 
+
Martin, B. A., W. Kalata, et al. (2005). "Syringomyelia hydrodynamics: an in vitro study based on in vivo measurements." J Biomech Eng 127(7): 1110-20.
2. Alperin NJ, Lee SH, Loth F, Raksin PB, Lichtor T: MR-Intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study. Radiology 217:877-885, 2000
+
Santini, F., S. G. Wetzel, et al. (2009). "Time-resolved three-dimensional (3D) phase-contrast (PC) balanced steady-state free precession (bSSFP)." Magn Reson Med.
 
 
3. Kalata W: Numerical simulation of cerebrospinal fluid motion within the spinal canal. Masters Thesis Chicago, University of Illinois at Chicago, 2002
 
 
 
4. Martin BA, Kalata W, Loth F, Royston TJ, Oshinski JN: Syringomyelia hydrodynamics: an in vitro study based on in vivo measurements. J Biomech Eng 127:1110-1120, 2005
 
 
 
5. Santini F, Wetzel SG, Bock J, Markl M, Scheffler K: Time-resolved three-dimensional (3D) phase-contrast (PC) balanced steady-state free precession (bSSFP). Magn Reson Med, 2009
 

Revision as of 13:42, 30 March 2010

Personel

The problem

Craniospinal compliance has been thought to be an important indicator of craniospinal health. However, a non-invasive technique for assessment of craniospinal compliance is not available. The proposed pilot study aims to investigate the feasibility of a novel non-invasive 4D MR flow quantification technique (Santini, Wetzel et al. 2009) to measure the relative distribution of volumetric compliance of the spinal subarachnoid space (SSS) (Figure 1).

The volumetric compensation of SSS to the cerebrospinal fluid pulsations (CSF) can be measured by determining the instantaneous difference of flow into and out of a SSS control volume. If the entire flow field in the SSS is known (Santini, Wetzel et al. 2009), then it is possible to obtain the relative distribution of compliance along the spinal canal.

Hypothesis and research objectives

We hypothesize that in healthy persons most of the volumetric compensation of the CSF pulsation takes place in the cervical subarachnoid space. The goal of this research is thus to measure the distribution of spinal SAS compliance in healthy subjects using two novel MR protocols.

Methods and study outline

A. In vivo MR measurements.

Our approach is to obtain CSF flow velocity measurements on three age-matched healthy subjects using the following protocols.

1. For SA1b, high-resolution balanced-steady-state free procession cine (bSSFP) images gated to the cardiac cycle will be obtained from a healthy subject at the various vertebrae levels (i.e. C2, C8, and T4 as in Figure 10). These cine loops will be acquired for at least 25 frames over the cardiac cycle and be used to investigate the distribution of spinal SAS compliance.

2. For SA1c, and SA1d, flow measurements in cranial (c) and spinal (d) SAS will be conducted using the protocol developed by Santini et al. (Figure 10) (Santini, Wetzel et al. 2009). Subjects will be asked to lie in the supine position in the scanner bed with a standard 12-channel head coil and neck coil (Siemens Medical Solutions). CSF flow measurements will be performed in healthy volunteers in the spinal SAS (C2 to lumbar if possible), hindbrain, and ventricles with the following imaging parameters: venc = 10 cm/s, TE = 6 ms, TR = 12 ms, flip angle = 70°. Total scan time for each subject will be approximately 20 min.

3. Repeatability will be examined by obtaining measurements in 1) and 2) on the same subject three times.

B. Processing of MR data.

The relative distribution of spinal canal compliance will be calculated based on the CSF flow velocity measurements

1. CSF flow waveforms in the spinal SAS will be obtained from the recorded velocity for each pixel from pcMR images. Pixel velocity will be integrated over a manually selected cross-sectional ROI for an entire cardiac cycle as detailed by Kalata (Kalata 2002). The basic equation for this process is given by , where Apixel is the area of one MRI pixel, Vpixel is the velocity for the corresponding pixel, and Q(t) is the summation of the flow for each pixel of interest.

2. Using a technique similar to Martin et al. (Kalata 2002; Martin, Kalata et al. 2005), the volume change of a section of the spinal SAS will be computed as follows. A control volume will be defined by two parallel planes that are each orthogonal to CSF flow separated by a distance (L). The volume flux of the ROI will be computed by integration of the flow difference into and out-of the ROI.

3. Thus, If the entire 4D flow field in the SAS is known (Santini, Wetzel et al. 2009), then it is possible to obtain the relative distribution of compliance along the entire spinal canal using the provided techniques.

Expected results and potential impact

The proposed work will determine if the non-invasive MR protocol is capable of measuring the distribution of compliance in the spinal canal in healthy volunteers. If proven efficacious, the test could be further explored with patients, and has the potential to provide a clinically useful tool for assessment of relative distribution in craniospinal compliance.

Preliminary results

To be posted

References

Kalata, W. (2002). "Numerical simulation of cerebrospinal fluid motion within the spinal canal." Masters Thesis Chicago, University of Illinois at Chicago. Martin, B. A., W. Kalata, et al. (2005). "Syringomyelia hydrodynamics: an in vitro study based on in vivo measurements." J Biomech Eng 127(7): 1110-20. Santini, F., S. G. Wetzel, et al. (2009). "Time-resolved three-dimensional (3D) phase-contrast (PC) balanced steady-state free precession (bSSFP)." Magn Reson Med.