Quantitative comparison of 4D MRI flow measurements to 3D computational fluid dynamics simulation of cerebrospinal fluid movement in the spinal subarachnoid space

Computational fluid dynamic (CFD) simulations have provided detailed information about the complex flow and pressure field within the cerebrospinal fluid (CSF) system. The solutions of these simulations are sensitive to boundary conditions and thus need validation with in vivo measurements. However, validation of CFD flow results and MRI CSF flow measurements have been limited to through-plane pcMR measurements. Recent advancements in MRI flow measurement technology has enabled measurement of the 4D flow field within the spinal subarachnoid space (SSS), superior sagittal sinus and ventricles of the brain. Alterations in cerebrospinal fluid (CSF) dynamics have been associated with neurological symptoms and formation of Syringomyelia in patients with Chiari malformation and spinal stenosis. In these patients, analysis of morphology alone has proved to be insufficient in explaining the absence or presence of symptoms. In the present study, we compare quantitatively 4D flow measurements to CFD analysis within the SSS (C1-T1, cervical spinal segment) of a healthy volunteer without any lesions at the craniocervical junction or the cervical spinal canal.