Automated quantitation of spinal CSF volume and measurement of craniospinal csf redistribution following lumbar withdrawal in idiopathic intracranial hypertension

Noam Alperin, A. M. Bagci, S. H. Lee, Byron L Lam

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11 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Automated methods for quantitation of tissue and CSF volumes by MR imaging are available for the cranial but not the spinal compartment. We developed an iterative method for delineation of the spinal CSF spaces for automated measurements of CSF and cord volumes and applied it to study craniospinal CSF redistribution following lumbar withdrawal in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS: MR imaging data were obtained from 2 healthy subjects and 8 patients with idiopathic intracranial hypertension who were scanned before, immediately after, and 2 weeks after diagnostic lumbar puncture. Imaging included T1-weighted and T2-weighted sequences of the brain and T2-weighted scans of the spine. Repeat scans in 4 subjects were used to assess measurement reproducibility. Whole CNS CSF volumes measured prior to and following lumbar puncture were compared with the withdrawn amounts of CSF. RESULTS: CSF and cord volume measurements were highly reproducible with mean variabilities of =0.7% < 1.4% and =0.7% < 1.0%, respectively. Mean spinal CSF volume was 77.5<8.4 mL. The imaging-based pre-to post-CSF volume differences were consistently smaller and strongly correlated with the amounts removed (R=0.86, P=.006), primarily from the lumbosacral region. These differences are explained by net CSF formation of 0.41 < 0.18 mL/min between withdrawal and imaging. CONCLUSIONS: Automated measurements of the craniospinal CSF redistribution following lumbar withdrawal in idiopathic intracranial hypertension reveal that the drop in intracranial pressure following lumbar puncture is primarily related to the increase in spinal compliance and not cranial compliance due to the reduced spinal CSF volume and the nearly unchanged cranial CSF volume.

Original languageEnglish (US)
Pages (from-to)1957-1963
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume37
Issue number10
DOIs
StatePublished - Oct 1 2016

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Pseudotumor Cerebri
Spinal Puncture
Compliance
Lumbosacral Region
Intracranial Pressure
Healthy Volunteers
Spine
Brain

Keywords

  • IIH=idiopathic intracranial hypertension
  • LP=lumbar puncture

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

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title = "Automated quantitation of spinal CSF volume and measurement of craniospinal csf redistribution following lumbar withdrawal in idiopathic intracranial hypertension",
abstract = "BACKGROUND AND PURPOSE: Automated methods for quantitation of tissue and CSF volumes by MR imaging are available for the cranial but not the spinal compartment. We developed an iterative method for delineation of the spinal CSF spaces for automated measurements of CSF and cord volumes and applied it to study craniospinal CSF redistribution following lumbar withdrawal in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS: MR imaging data were obtained from 2 healthy subjects and 8 patients with idiopathic intracranial hypertension who were scanned before, immediately after, and 2 weeks after diagnostic lumbar puncture. Imaging included T1-weighted and T2-weighted sequences of the brain and T2-weighted scans of the spine. Repeat scans in 4 subjects were used to assess measurement reproducibility. Whole CNS CSF volumes measured prior to and following lumbar puncture were compared with the withdrawn amounts of CSF. RESULTS: CSF and cord volume measurements were highly reproducible with mean variabilities of =0.7{\%} < 1.4{\%} and =0.7{\%} < 1.0{\%}, respectively. Mean spinal CSF volume was 77.5<8.4 mL. The imaging-based pre-to post-CSF volume differences were consistently smaller and strongly correlated with the amounts removed (R=0.86, P=.006), primarily from the lumbosacral region. These differences are explained by net CSF formation of 0.41 < 0.18 mL/min between withdrawal and imaging. CONCLUSIONS: Automated measurements of the craniospinal CSF redistribution following lumbar withdrawal in idiopathic intracranial hypertension reveal that the drop in intracranial pressure following lumbar puncture is primarily related to the increase in spinal compliance and not cranial compliance due to the reduced spinal CSF volume and the nearly unchanged cranial CSF volume.",
keywords = "IIH=idiopathic intracranial hypertension, LP=lumbar puncture",
author = "Noam Alperin and Bagci, {A. M.} and Lee, {S. H.} and Lam, {Byron L}",
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T1 - Automated quantitation of spinal CSF volume and measurement of craniospinal csf redistribution following lumbar withdrawal in idiopathic intracranial hypertension

AU - Alperin, Noam

AU - Bagci, A. M.

AU - Lee, S. H.

AU - Lam, Byron L

PY - 2016/10/1

Y1 - 2016/10/1

N2 - BACKGROUND AND PURPOSE: Automated methods for quantitation of tissue and CSF volumes by MR imaging are available for the cranial but not the spinal compartment. We developed an iterative method for delineation of the spinal CSF spaces for automated measurements of CSF and cord volumes and applied it to study craniospinal CSF redistribution following lumbar withdrawal in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS: MR imaging data were obtained from 2 healthy subjects and 8 patients with idiopathic intracranial hypertension who were scanned before, immediately after, and 2 weeks after diagnostic lumbar puncture. Imaging included T1-weighted and T2-weighted sequences of the brain and T2-weighted scans of the spine. Repeat scans in 4 subjects were used to assess measurement reproducibility. Whole CNS CSF volumes measured prior to and following lumbar puncture were compared with the withdrawn amounts of CSF. RESULTS: CSF and cord volume measurements were highly reproducible with mean variabilities of =0.7% < 1.4% and =0.7% < 1.0%, respectively. Mean spinal CSF volume was 77.5<8.4 mL. The imaging-based pre-to post-CSF volume differences were consistently smaller and strongly correlated with the amounts removed (R=0.86, P=.006), primarily from the lumbosacral region. These differences are explained by net CSF formation of 0.41 < 0.18 mL/min between withdrawal and imaging. CONCLUSIONS: Automated measurements of the craniospinal CSF redistribution following lumbar withdrawal in idiopathic intracranial hypertension reveal that the drop in intracranial pressure following lumbar puncture is primarily related to the increase in spinal compliance and not cranial compliance due to the reduced spinal CSF volume and the nearly unchanged cranial CSF volume.

AB - BACKGROUND AND PURPOSE: Automated methods for quantitation of tissue and CSF volumes by MR imaging are available for the cranial but not the spinal compartment. We developed an iterative method for delineation of the spinal CSF spaces for automated measurements of CSF and cord volumes and applied it to study craniospinal CSF redistribution following lumbar withdrawal in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS: MR imaging data were obtained from 2 healthy subjects and 8 patients with idiopathic intracranial hypertension who were scanned before, immediately after, and 2 weeks after diagnostic lumbar puncture. Imaging included T1-weighted and T2-weighted sequences of the brain and T2-weighted scans of the spine. Repeat scans in 4 subjects were used to assess measurement reproducibility. Whole CNS CSF volumes measured prior to and following lumbar puncture were compared with the withdrawn amounts of CSF. RESULTS: CSF and cord volume measurements were highly reproducible with mean variabilities of =0.7% < 1.4% and =0.7% < 1.0%, respectively. Mean spinal CSF volume was 77.5<8.4 mL. The imaging-based pre-to post-CSF volume differences were consistently smaller and strongly correlated with the amounts removed (R=0.86, P=.006), primarily from the lumbosacral region. These differences are explained by net CSF formation of 0.41 < 0.18 mL/min between withdrawal and imaging. CONCLUSIONS: Automated measurements of the craniospinal CSF redistribution following lumbar withdrawal in idiopathic intracranial hypertension reveal that the drop in intracranial pressure following lumbar puncture is primarily related to the increase in spinal compliance and not cranial compliance due to the reduced spinal CSF volume and the nearly unchanged cranial CSF volume.

KW - IIH=idiopathic intracranial hypertension

KW - LP=lumbar puncture

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