| Objectives: The aim of this study was to analysis cerebrospinal fluid(CSF)flow quantification in the cerebral aqueduct using cine phase-contrast magnetic resonance imaging(MRI) technique in normal children and to provide normative data in three different age groups.Materials and methods: 48 Subjects(28males and 20 females) with no cerebral pathology were included in this study,whose age ranged from 3 months to 14 years.The Subjects were divided into three age groups: <1 years(n=11), 1–6 years(n=23), >6 years(n=14). Phase-contrast cine MRI was performed on a 1.5 T MR. Cardiac-gated, flow-compensated GRE sequence with flow encoding was used, with flow velocity encoding direction from cranial and caudal. The aqueduct was visualized using a sagittal T2 weighted sequence. Rephrase and magnitude images were acquired perpendicular to the cerebral aqueduct at three different anatomical levels: the inlet, ampulla and pars posterior. Region-of-interest(ROI) was drawn in the magnitude images. The Region of interest(ROI) analysis of cerebrospinal fluid dynamics, including the peak positive velocity(cm / s), peak negative velocity(cm / s), positive flow volumes(ml / beat), negative flow volumes(ml / beat), the net flow(ml / beat), and the positive rate of time to peak. Analysis comparatively the same anatomical measurement sites in different age and different anatomical measurement parts of the same age.Results: 1. The comparisons of different ages in the same anatomical localization.(1) The inlet levels of aqueduct: The mean and standard deviation of PPV in each group were 5.59±2.26cm/s, 7.80±3.56cm/s and 5.46±2.50cm/s. There was statistically significant difference between the Peak positive velocity of group aged 1-6 years and>6 years( P=0.008). The mean and standard deviation of PNV in each group were-6.71±2.18cm/s,-8.33±2.88cm/s and-5.97±2.21cm/s. There was statistical significance difference between the age group of 1-6 years and the>6 age groups(P=0.025).The mean and standard deviation of PFV in each group were 0.019±0.011ml/beat, 0.046±0.022ml/beat and 0.038±0.017ml/beat. The PFV in the <1 age groups was significant difference with 1-6 and >6 age groups(P=0.000,P=0.007,respectively). The mean and standard deviation of NFV in each group were-0.018±0.009ml/beat,-0.041±0.025ml/beat and-0.032±0.011ml/beat. The NFV in the <1 age groups was significant difference with 1-6 and >6 age groups(P=0.001,P=0.01,respectively). The mean and standard deviation of NV in each group were 0.001±0.002ml/beat、0.003±0.014ml/beat and 0.007±0.011ml/beat. While there these differences were not statistically significant among age groups(F=0.681,P=0.511). The mean and standard deviation of NV in total group were 0.003±0.012ml/beat. The mean and standard deviation of the positive rate of time to peak in each group were 125.64±30.5ms,150.91±54.7ms and118.51±44.5ms.While there these differences were not statistically significant among age groups(F=2.385,P=0.106). The mean and standard deviation of the positive rate of time to peak in total group were 135.71±48.7ms.(2) The ampulla levels of aqueduct: The mean and standard deviation of PPV in each group were 7.98±4.08cm/s,10.19±3.37cm/s and 6.41±2.08cm/s. There was statistically significant difference between the PPV of group aged 1-6 years and>6 years( P=0.000). The mean and standard deviation of PNV in each group were-7.87±3.51cm/s,-10.47±3.48cm/s and-6.35±1.98cm/s. There was statistically significant difference between the PPV of group aged 1-6 years and>6 years( P=0.000). The mean and standard deviation of PFV in each group were 0.022±0.011ml/beat, 0.047±0.021ml/beat and 0.042±0.017ml/beat. The PFV in the <1 age groups was significant difference with 1-6 and >6 age groups(P=0.000,P=0.006,respectively). The mean and standard deviation of NFV in each group were-0.020±0.011ml/beat,-0.041±0.022ml/beat and-0.036±0.013ml/beat. The NFV in the <1 age groups was significant difference with 1-6 and >6 age groups(P=0.002,P=0.011,respectively). The mean and standard deviation of NV in each group were 0.001±0.002ml/beat, 0.003±0.008ml/beat and 0.009±0.009ml/beat. There was statistical significance between the groups aged <1 years and>6 years(P=0.024).The mean and standard deviation of the positive rate of time to peak in each group were 134.82±25.21 ms, 160.13±48.64 ms and 115.07±40.57 ms. There was statistical significance between the groups aged 1-6 years and>6 years(P=0.014).(3) The parsposterior levels of aqueduct: The mean and standard deviation of PPV in each group were 9.95±2.62cm/s,10.55±3.27cm/s and 7.23±2.41cm/s. The PPV in the >6 age groups was significant difference with 1-6 and <1 age groups(P=0.004,P=0.044, respectively). The mean and standard deviation of PNV in each group were-7.46±2.91cm/s,-8.41±4.19cm/s and-5.55±1.76cm/s. There was no statistical significance between the age groups(F=3.124,P=0.054). The mean and standard deviation of PFV in each group were 0.023±0.008ml/beat, 0.051±0.025ml/beat and 0.039±0.015ml/beat. The PFV in the <1 age groups was significant difference with 1-6 and >6 age groups(P=0.000,P=0.010,respectively).The mean and standard deviation of NFV in each group were-0.019±0.008ml/beat,-0.041±0.025ml/beat and-0.029±0.009ml/beat. The NFV in the <1 age groups was significant difference with 1-6 and >6 age groups(P=0.003,P=0.023,respectively). The mean and standard deviation of NV in each group were0.004±0.003ml/beat, 0.009±0.017ml/beat and 0.009±0.009ml/beat. While there these differences were not statistically significant among age groups(F=0.761,P=0.279). The mean and standard deviation of NV in total group were 0.008±0.013ml/beat. The mean and standard deviation of the positive rate of time to peak in each group were 125.72±37.1ms, 170.17±55.5ms and 138.11±32.9ms. There was statistical significance between the groups aged 1-6 years and>6 years(P=0.030). 2. The comparisons of different anatomical localization in the same ages. The PPV showed significant difference in different anatomical localization(F=31.611,P=0.000), the flow rate of lower segment were faster than the upper ones. There were no statistically significant differences in PNV, PNV, PFV, NFV, NV and the positive rate of time to peak among different anatomical localization(P>0.05). Statistically significant differences were not detected in different anatomical localization flow parameters between age(F=1.975,P=0.105).Conclusion: We obtained a set of reference data of the CSF flow parameter through the cerebral aqueduct in different ages of young healthy volunteers. When performing age-dependent clinical studies including adolescents, should adopt different standards of normal value.The same anatomic level PPV 1-6 and > 6 age groups was statistically significantwere compared, the positive / negative to the flow of < 1 1-6, age group and > 6 age group comparison had statistical significance. The PPV showed significant difference in different anatomical localization, but the other flow parameter showed no statistically significant differences. Statistically significant differences were not detected between age and different anatomical localization flow parameters. |
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