Spinal CSF flow in response to forced thoracic and abdominal respiration

被引:52
作者
Aktas, Goekmen [1 ]
Kollmeier, Jost M. [2 ]
Joseph, Arun A. [2 ,3 ]
Merboldt, Klaus-Dietmar [2 ]
Ludwig, Hans-Christoph [4 ]
Gaertner, Jutta [5 ]
Frahm, Jens [2 ,3 ]
Dreha-Kulaczewski, Steffi [5 ]
机构
[1] Univ Med Ctr Gottingen, Sch Med, D-37075 Gottingen, Germany
[2] Max Planck Inst Biophys Chem, Biomed NMR, D-37077 Gottingen, Germany
[3] DZHK German Ctr Cardiovasc Res, Partner Site Gottingen, Gottingen, Germany
[4] Univ Med Ctr Gottingen, Dept Neurosurg, Div Pediat Neurosurg, D-37075 Gottingen, Germany
[5] Univ Med Ctr Gottingen, Dept Pediat & Adolescent Med, Div Pediat Neurol, D-37075 Gottingen, Germany
关键词
Flow-sensitive real-time MRI; CSF dynamics; Respiration; Hydrocephalus; Intrathoracic pressure; Intraabdominal pressure; CEREBROSPINAL-FLUID DYNAMICS; SPECTRAL-ANALYSIS; MRI; MOVEMENT; INFANTS; PHYSIOLOGY; RESOLUTION; VOLUME;
D O I
10.1186/s12987-019-0130-0
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Respiration-induced pressure changes represent a powerful driving force of CSF dynamics as previously demonstrated using flow-sensitive real-time magnetic resonance imaging (MRI). The purpose of the present study was to elucidate the sensitivity of CSF flow along the spinal canal to forced thoracic versus abdominal respiration. Methods: Eighteen subjects without known illness were studied using real-time phase-contrast flow MRI at 3 T in the aqueduct and along the spinal canal at levels C3, Th1, Th8 and L3. Subjects performed a protocol of forced breathing comprising four cycles of 2.5 s inspiration and 2.5 s expiration. Results: The quantitative results for spinal CSF flow rates and volumes confirm previous findings of an upward movement during forced inspiration and reversed downward flow during subsequent exhalation-for both breathing types. However, the effects were more pronounced for abdominal than for thoracic breathing, in particular at spinal levels Th8 and L3. In general, CSF net flow volumes were very similar for both breathing conditions pointing upwards in all locations. Conclusions: Spinal CSF dynamics are sensitive to varying respiratory performances. The different CSF flow volumes in response to deep thoracic versus abdominal breathing reflect instantaneous adjustments of intrathoracic and intraabdominal pressure, respectively. Real-time MRI access to CSF flow in response to defined respiration patterns will be of clinical importance for patients with disturbed CSF circulation like hydrocephalus, pseudotumor cerebri and others.
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