IJSR - International Journal of Scientific Research

CHOPRA SANJEEV; JAIN SURENDRA; SINHA VIRENDRA DEV

Volume : IX, Issue : VIII, August - 2020

TO STUDY CLINICAL SIGNIFICANCE OF CARDIAC GATED PHASE CONTRAST MRI IN PATIENTS WITH CHIARI MALFORMATION I

Chopra Sanjeev, Jain Surendra, Sinha Virendra Dev

Abstract :

BACKGROUND AND PURPOSE: CSF motion is a combined effect of CSF production rate and superimposed cardiac pulsations. There are several disorders like communicating and non–communicating hydrocephalus, chiari malformation , syringomyelic cyst and arachnoid cyst that can change the CSF dynamics .Flow of CSF through the foramen magnum has been implicated in the symptoms of Chiari I malformation. The purpose of this study was to establish relationship between peak CSF velocity at the foramen magnum and symptoms in patients diagnosed with Chiari I malformation. METHODS: Sixteen symptomatic patients of Chiari I malformations were studied with cardiac gated phase–contrast MR imaging in the axial plane at the foramen magnum preoperatively and post operatively. The flow velocity of CSF (peak systolic and peak diastolic velocity) in the foramen magnum were assessed at thirteen time frames within the r–r interval. The velocity in each of the voxels at each of the time frames was calculated and the peak systolic and diastolic velocities preoperatively and post operatively were tabulated for each patient. The association between peak CSF velocity and symptoms were assessed. RESULTS: Sixteen patients with Chiari I malformation were studied. Peak systolic velocities significantly diminished after surgery in fifteen patients on average from 9.82 cm/s to 6.41cm/s ( p= <0.05) and peak diastolic velocity diminished in fifteen patients from 8.46 cm/s to 5.42 cm/s(p =< 0.05). Decrease in systolic and diastolic CSF velocities was associated with symptom resolution. CONCLUSION: Craniocervical decompression in Chiari I malformation decreases peak systolic and diastolic velocities with improvement of symptoms.