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Gwendolyn Williams
University of Idaho College of Engineering
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Background: Phase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice for Chiari malformation diagnostics. To improve these diagnostic practices, a better understanding of PC MRI based measurement agreement, repeatability, and reproducibility of CSF dynamics is needed.
Methods: An anatomically realistic in vitro subject specific model of a Chiari malformation patient was scanned three times at five different scanning centers using 2D PC MRI and 4D Flow techniques to quantify intra-scanner repeatability, inter-scanner reproducibility, and agreement between imaging modalities. Peak systolic CSF velocities were measured at nine axial planes using 2D PC MRI, which were then compared to 4D Flow peak systolic velocity measurements extracted at those exact axial positions along the model.
Results: Comparison of measurement results showed good overall agreement of CSF velocity detection between 2D PC MRI and 4D Flow (p = 0.86), fair intra-scanner repeatability (confidence intervals ±1.5 cm/s), and poor inter-scanner reproducibility. On average, 4D Flow measurements had a larger variability than 2D PC MRI measurements (standard deviations 1.83 and 1.04 cm/s, respectively).
Conclusion: Agreement, repeatability, and reproducibility of 2D PC MRI and 4D Flow detection of peak CSF velocities was quantified using a patient-specific in vitro model of Chiari malformation. In combination, the greatest factor leading to measurement inconsistency was determined to be a lack of reproducibility between different MRI centers. Overall, these findings may help lead to better understanding for application of 2D PC MRI and 4D Flow techniques as diagnostic tools for CSF dynamics quantification in Chiari malformation and related diseases.
Keywords
Cerebrospinal fluid, Phase contrast, Magnetic resonance imaging, Chiari malformation, Spinal cord
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View the published article at Fluids and Barriers of the CNS.
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See the published version of this preprint at Fluids and Barriers of the CNS.
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Research
Gwendolyn Williams
University of Idaho College of Engineering
Corresponding Author
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Complete author information
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at Fluids and Barriers of the CNS.
Version 2
Posted 26 Jan, 2021
No community comments so far
Editorial decision: Minor revision
On 29 Jan, 2021
Review #1 received
Received 28 Jan, 2021
Review #2 received
Received 24 Jan, 2021
Review #3 received
Received 22 Jan, 2021
Reviewer #3 agreed
On 18 Jan, 2021
Reviewer #2 agreed
On 16 Jan, 2021
Reviewers invited
Invitations sent on 15 Jan, 2021
Reviewer #1 agreed
On 15 Jan, 2021
Editor assigned
On 14 Jan, 2021
Submission checks complete
On 14 Jan, 2021
Editor invited
On 14 Jan, 2021
No comments provided
Editorial decision: Major revision
On 13 Dec, 2020
Review #2 received
Received 04 Dec, 2020
Review #3 received
Received 04 Dec, 2020
Review #1 received
Received 01 Dec, 2020
Review #4 received
Received 29 Nov, 2020
Reviewer #4 agreed
On 18 Nov, 2020
Reviewer #3 agreed
On 18 Nov, 2020
Reviewer #2 agreed
On 17 Nov, 2020
Reviewer #1 agreed
On 17 Nov, 2020
Editor assigned
On 16 Nov, 2020
Reviewers invited
Invitations sent on 16 Nov, 2020
Editor invited
On 16 Nov, 2020
Submission checks complete
On 16 Nov, 2020
First submitted
On 10 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Fluids and Barriers of the CNS.
Background: Phase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice for Chiari malformation diagnostics. To improve these diagnostic practices, a better understanding of PC MRI based measurement agreement, repeatability, and reproducibility of CSF dynamics is needed.
Methods: An anatomically realistic in vitro subject specific model of a Chiari malformation patient was scanned three times at five different scanning centers using 2D PC MRI and 4D Flow techniques to quantify intra-scanner repeatability, inter-scanner reproducibility, and agreement between imaging modalities. Peak systolic CSF velocities were measured at nine axial planes using 2D PC MRI, which were then compared to 4D Flow peak systolic velocity measurements extracted at those exact axial positions along the model.
Results: Comparison of measurement results showed good overall agreement of CSF velocity detection between 2D PC MRI and 4D Flow (p = 0.86), fair intra-scanner repeatability (confidence intervals ±1.5 cm/s), and poor inter-scanner reproducibility. On average, 4D Flow measurements had a larger variability than 2D PC MRI measurements (standard deviations 1.83 and 1.04 cm/s, respectively).
Conclusion: Agreement, repeatability, and reproducibility of 2D PC MRI and 4D Flow detection of peak CSF velocities was quantified using a patient-specific in vitro model of Chiari malformation. In combination, the greatest factor leading to measurement inconsistency was determined to be a lack of reproducibility between different MRI centers. Overall, these findings may help lead to better understanding for application of 2D PC MRI and 4D Flow techniques as diagnostic tools for CSF dynamics quantification in Chiari malformation and related diseases.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
The full text of this article is available to read as a PDF.
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