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. 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. 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). 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.

中文翻译：

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I 型 Chiari 畸形脑脊液速度测量的体外评估：使用 2D 相差和 4D 流 MRI 的重复性、再现性和一致性


相衬磁共振成像（PC MRI）是一种有价值的工具，可以无创地量化脑脊液动力学，但在 Chiari 畸形诊断的临床实践中缺乏采用。为了改进这些诊断实践，需要更好地了解基于 PC MRI 的 CSF 动态测量一致性、重复性和再现性。使用 2D PC MRI 和 4D Flow 技术，在五个不同的扫描中心对 Chiari 畸形患者的解剖学真实的体外受试者特定模型进行了 3 次扫描，以量化扫描仪内的重复性、扫描仪间的再现性以及成像模式之间的一致性。使用 2D PC MRI 在 9 个轴向平面测量峰值收缩 CSF 速度，然后将其与在沿模型的这些精确轴向位置提取的 4D Flow 峰值收缩速度测量值进行比较。测量结果比较显示，2D PC MRI 和 4D Flow 之间的 CSF 速度检测总体一致性良好 (p = 0.86)，扫描仪内重复性良好（置信区间 ± 1.5 cm/s），但扫描仪间重复性较差。平均而言，4D Flow 测量值比 2D PC MRI 测量值具有更大的变异性（标准差分别为 1.83 和 1.04 cm/s）。使用患者特异性 Chiari 畸形体外模型对 2D PC MRI 和 4D Flow 峰值 CSF 速度检测的一致性、重复性和再现性进行量化。综合起来，导致测量不一致的最大因素被确定为不同 MRI 中心之间缺乏可重复性。 总体而言，这些发现可能有助于更好地理解 2D PC MRI 和 4D Flow 技术作为 Chiari 畸形及相关疾病的 CSF 动态定量诊断工具的应用。