With the advent of real-time MRI, the motion and passage of cerebrospinal fluid can be visualized without gating and exclusion of low-frequency waves. This imaging modality gives insights into low-volume, rapidly oscillating cardiac-driven movement as well as sustained, high-volume, slowly oscillating inspiration-driven movement. Inspiration means a spontaneous or artificial increase in the intrathoracic dimensions independent of body position. Alterations in thoracic diameter enable the thoracic and spinal epidural venous compartments to be emptied and filled, producing an upward surge of cerebrospinal fluid inside the spine during inspiration; this surge counterbalances the downward pooling of venous blood toward the heart. Real-time MRI, as a macroscale in vivo observation method, could expand our knowledge of neurofluid dynamics, including how astrocytic fluid preloading is adjusted and how brain buoyancy and turgor are maintained in different postures and zero gravity. Along with these macroscale findings, new microscale insights into aquaporin-mediated fluid transfer, its sensing by cilia, and its tuning by nitric oxide will be reviewed. By incorporating clinical knowledge spanning several disciplines, certain disorders—congenital hydrocephalus with Chiari malformation, idiopathic intracranial hypertension, and adult idiopathic hydrocephalus—are interpreted and reviewed according to current concepts, from the basics of the interrelated systems to their pathology.

中文翻译：

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神经液——星形细胞网络的深层灵感、纤毛和预加载

随着实时 MRI 的出现，脑脊液的运动和通道可以被可视化，而无需门控和排除低频波。这种成像方式可以深入了解低容量、快速振荡的心脏驱动运动以及持续、高容量、缓慢振荡的吸气驱动运动。灵感是指胸内尺寸的自发或人为增加，与身体位置无关。胸径的改变使胸腔和脊髓硬膜外静脉腔能够被排空和充盈，在吸气时在脊柱内产生向上涌动的脑脊液；这种激增抵消了向心脏向下汇集的静脉血。实时 MRI 作为一种宏观的体内观察方法，可以扩展我们对神经流体动力学的认识，包括如何调整星形胶质细胞的预紧力，以及如何在不同的姿势和零重力下保持大脑的浮力和膨胀。除了这些宏观发现之外，还将回顾对水通道蛋白介导的流体转移、纤毛感知和一氧化氮调节的新微观层面的见解。通过整合跨越多个学科的临床知识，某些疾病——先天性脑积水伴 Chiari 畸形、特发性颅内高压和成人特发性脑积水——根据当前概念进行解释和审查，从相关系统的基础知识到其病理学。将回顾对水通道蛋白介导的流体转移、纤毛感知以及一氧化氮调节的新的微尺度见解。通过整合跨越多个学科的临床知识，某些疾病——先天性脑积水伴 Chiari 畸形、特发性颅内高压和成人特发性脑积水——根据当前概念进行解释和审查，从相关系统的基础知识到其病理学。将回顾对水通道蛋白介导的流体转移、纤毛感知以及一氧化氮调节的新的微尺度见解。通过整合跨越多个学科的临床知识，某些疾病——先天性脑积水伴 Chiari 畸形、特发性颅内高压和成人特发性脑积水——根据当前概念进行解释和审查，从相关系统的基础知识到其病理学。