Assessment of cerebrospinal fluid hydrodynamics in patients with Chiari malformation I using highly accelerated multi-dimensional phase-contrast MRI

• Applicant: Dr. Daniel Giese, Ph.D.
• Subject Area: Medical Physics, Biomedical Technology ; Clinical Neurology; Neurosurgery and Neuroradiology ; Nuclear Medicine, Radiotherapy, Radiobiology
• Term: from 2016 to 2019
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 317275652

Chiari Malformation I is a neurological condition caused by structural alterations of the posterior cranial fossa. While it is known that hydrodynamics of the cerebrospinal fluid are altered in these patients, controversy exists with respect to their diagnostic value and their potential to guide and monitor treatment. A main reason for the conflicting data can be attributed to the shortcomings of currently available techniques to measure cerebrospinal fluid hydrodynamics. 4D flow MRI allows for a non-invasive time-resolved, multi-dimensional acquisition of cerebrospinal fluid velocities. The methods applicability in a clinical context is however significantly hampered by long acquisition times and its limited accuracy. The current project aims to address these shortcomings by developing a robust and clinically feasible MRI flow acquisition method. This requires an increased sensitivity for a wider velocity spectrum combined with a significantly shortened scan time by applying undersampling strategies which harvest data similarity in multi-dimensional flow MRI data. The validation process of the novel methods developed in our study will include numerical simulations, phantom measurements and flow acquisitions in healthy volunteers. Its clinical feasibility will be confirmed by a pilot study in 20 patients with Chiari Malformation I. Patient data including hydrodynamic parameters such as pressure differences and pulse wave velocities will be analysed and compared to healthy volunteers. The project is warranted to allow insights into the pathophysiology of cerebrospinal fluid alterations in patients with Chiari Malformation I and ultimately aims at contributing to the development of new quantitative imaging biomarkers in the diagnostic work-up of these patients.

• DFG Programme: Research Grants