Evaluating the Effect of Arterial Pulsation on Cerebrospinal Fluid Motion in the Sylvian Fissure of Patients with Middle Cerebral Artery Occlusion Using Low b-value Diffusion-weighted Imaging

  • Taoka Toshiaki
    Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine Department of Radiology, Nagoya University Graduate School of Medicine
  • Kawai Hisashi
    Department of Radiology, Nagoya University Graduate School of Medicine
  • Nakane Toshiki
    Department of Radiology, Nagoya University Graduate School of Medicine
  • Abe Takashi
    Department of Radiology, Nagoya University Graduate School of Medicine
  • Nakamichi Rei
    Department of Radiology, Nagoya University Graduate School of Medicine
  • Ito Rintaro
    Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine Department of Radiology, Nagoya University Graduate School of Medicine
  • Sasaki Yutaro
    Department of Radiology, Nagoya University Graduate School of Medicine
  • Nishida Ayumi
    Department of Radiology, Nagoya University Graduate School of Medicine
  • Naganawa Shinji
    Department of Radiology, Nagoya University Graduate School of Medicine

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<p>Purpose: Decrease in signal of the cerebrospinal fluid (CSF) on low b-value diffusion weighted image (DWI) due to non-uniform flow can provide additional information regarding CSF motion. The purpose of the current study was to evaluate whether arterial pulsations constitute the driving force of CSF motion.</p><p>Methods: We evaluated the CSF signals within the Sylvian fissure on low b-value DWI in 19 patients with unilateral middle cerebral artery (MCA) occlusion. DWI with b-value of 500 s/mm2 was evaluated for a decrease in CSF signal within the Sylvian fissure including the Sylvian vallecula and lower, middle, and higher Sylvian fissures and graded as follows: the same as contralateral side; smaller signal decrease than that on contralateral side; and no signal decrease. MR angiography (MRA) findings of MCA were graded as follows: the same as contralateral, lower signal than contralateral signal, and no signal. In 15 patients, regional cerebral blood flow (rCBF) was evaluated using single-photon emission computed tomography (SPECT) studies and graded as >90%, 90%–70%, and <70% rCBF compared to contralateral. The correlations between the gradings were evaluated using G likelihood-ratio test.</p><p>Results: There was no statistically significant correlation between the MRA and low b-value DWI gradings of CSF in all areas. There were statistically significant correlations between the decreases in CBF on SPECT and CSF signals in the middle Sylvian fissure.</p><p>Conclusion: The driving force of CSF pulsation in the Sylvian sinus may be related to the pulsations of the cerebral hemisphere rather than direct arterial pulsations.</p>

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