Fetal dynamic phase-contrast MR angiography using ultrasound gating and comparison with Doppler ultrasound measurements.

OBJECTIVES: To investigate the feasibility of fetal phase-contrast (PC)-MR angiography of the descending aorta (AoD) using an MR-compatible Doppler ultrasound sensor (DUS) for fetal cardiac gating and to compare velocimetry with Doppler ultrasound measurements. METHODS: In this prospective study, 2D PC-MR angiography was performed in 12 human fetuses (mean gestational age 32.8 weeks) using an MR-compatible DUS for gating of the fetal heart at 1.5 T. Peak flow velocities in the fetal AoD were compared with Doppler ultrasound measurements performed on the same day. Reproducibility of PC-MR measurements was tested by repeated PC-MR in five fetuses. RESULTS: Dynamic PC-MR angiography in the AoD was successfully performed in all fetuses using the DUS, with an average fetal heart rate of 140 bpm (range 129-163). Time-velocity curves revealed typical arterial blood flow patterns. PC-MR mean flow velocity and mean flux were 21.2 cm/s (range 8.6-36.8) and 8.4 ml/s (range 3.2-14.6), respectively. A positive association between PC-MR mean flux and stroke volume with gestational age was obtained (r = 0.66, p = 0.02 and r = 0.63, p = 0.03). PC-MR and Doppler ultrasound peak velocities revealed a highly significant correlation (r = 0.8, p < 0.002). Peak velocities were lower for PC-MR with 69.1 cm/s (range 39-125) compared with 96.7 cm/s (range 60-142) for Doppler ultrasound (p < 0.001). Reproducibility of PC-MR was high (p > 0.05). CONCLUSION: The MR-compatible DUS for fetal cardiac gating allows for PC-MR angiography in the fetal AoD. Comparison with Doppler ultrasound revealed a highly significant correlation of peak velocities with underestimation of PC-MR velocities. This new technique for direct fetal cardiac gating indicates the potential of PC-MR angiography for assessing fetal hemodynamics. KEY POINTS: • The developed MR-compatible Doppler ultrasound sensor allows direct fetal cardiac gating and can be used for prenatal dynamic cardiovascular MRI. • The MR-compatible Doppler ultrasound sensor was successfully applied to perform intrauterine phase-contrast MR angiography of the fetal aorta, which revealed a highly significant correlation with Doppler ultrasound measurements. • As fetal flow hemodynamics is an important parameter in the diagnosis and management of fetal pathologies, fetal phase-contrast MR angiography may offer an alternative imaging method in addition to Doppler ultrasound and develop as a second line tool in the evaluation of fetal flow hemodynamics.

Prospective comparison of diffusion-weighted MRI and dynamic Gd-EOB-DTPA-enhanced MRI for detection and staging of hepatic fibrosis in primary sclerosing cholangitis.

PURPOSE: To assess the diagnostic value of multiparametric magnetic resonance imaging (MRI) including dynamic Gd-EOB-DTPA-enhanced (DCE) and diffusion-weighted (DW) imaging for diagnosis and staging of hepatic fibrosis in primary sclerosing cholangitis (PSC) using transient elastography as a standard reference. MATERIAL AND METHODS: Multiparametric MRI was prospectively performed on a 3.0-Tesla scanner in 47 patients (age 43.9±14.3 years). Transient elastography derived liver stiffness measurements (LSM), DCE-MRI derived parameters (hepatocellular uptake rate (Ki), arterial (Fa), portal venous (Fv) and total (Ft) blood flow, mean transit time (MTT), and extracellular volume (Ve)) and the apparent diffusion coefficient (ADC) were calculated. Correlation and univariate analysis of variance with post hoc pairwise comparison were applied to test for differences between LSM derived fibrosis stages (F0/F1, F2/3, F4). ROC curve analysis was used as a performance measure. RESULTS: Both ADC and Ki correlated significantly with LSM (r= -0.614; p<0.001 and r= -0.368; p=0.01). The ADC significantly discriminated fibrosis stages F0/1 from F2/3 and F4 (p<0.001). Discrimination of F0/1 from F2/3 and F4 reached a sensitivity/specificity of 0.917/0.821 and 0.8/0.929, respectively. Despite significant inter-subject effect for classification of fibrosis stages, post hoc pairwise comparison was not significant for Ki (p>0.096 for F0/1 from F2/3 and F4). LSM, ADC and Ki were significantly associated with serum-based liver functional tests, disease duration and spleen volume. CONCLUSION: DW-MRI provides a higher diagnostic performance for detection of hepatic fibrosis and cirrhosis in PSC patients in comparison to Gd-EOB-DTPA-enhanced DCE-MRI. KEY POINTS: • Both ADC and hepatocellular uptake rate (Ki) correlate significantly with liver stiffness (r= -0.614; p<0.001 and r= -0.368; p=0.01). • The DCE-imaging derived quantitative parameter hepatocellular uptake rate (Ki) fails to discriminate pairwise intergroup differences of hepatic fibrosis (p>0.09). • DWI is preferable to DCE-imaging for discrimination of fibrosis stages F0/1 to F2/3 (p<0.001) and F4 (p<0.001).

Comparison of contrast-enhanced modified T1-weighted 3D TSE black-blood and 3D MP-RAGE sequences for the detection of cerebral metastases and brain tumours.

OBJECTIVES: To compare a modified T1-weighted 3D TSE black-blood sequence with sub-millimetre resolution (T1-mVISTA) with a magnetization-prepared rapid gradient echo (MP-RAGE) sequence for the diagnosis of cerebral malignomas. METHODS: Forty-six patients with known or suspected intracranial tumours and 15 control patients were included in this retrospective study. All patients underwent T1-mVISTA (0.75-mm isotropic resolution, 4:43 min) and MP-RAGE (0.8-mm isotropic resolution, 4:46 minutes) at 3-Tesla in random order after application of contrast agent. Two experienced radiologists determined the number of lesions. Maximum diameter, diagnostic confidence (DC), visual assessment of contrast enhancement (VCE) and CNRlesion/parenchyma were assessed for each lesion. RESULTS: Significantly more lesions were detected with T1-mVISTA compared to the MP-RAGE (61 vs. 36; p < 0.05). Further, DC and VCE was rated significantly higher in the T1-mVISTA (p < 0.05 and p < 0.001). Mean CNRlesion/parenchyma was twofold higher for T1-mVISTA (24.2 ± 17.5 vs. 12.7 ± 11.5, p < 0.001). The 25 lesions detected only in T1-mVISTA were significantly smaller than those detected in both sequences (4.3 ± 3.7 mm vs. 11.3 ± 10.7 mm; p < 0.01). CONCLUSIONS: T1-mVISTA increases the contrast of lesions significantly compared to MP-RAGE and might therefore improve detection rates of small lesions in early stages of disease. KEY POINTS: • T1-mVISTA leads to significantly higher contrast-to-noise ratios of cerebral malignomas. • T1-mVISTA detects significantly more metastatic lesions compared to 3D-MPRAGE. • Lesions detected only by T1-mVISTA are smaller than those detected in both sequences. • Diagnostic confidence is significantly higher for lesions detected by T1-mVISTA. • Application of T1-mVISTA might be of high relevance in early stages of disease.

Ewing sarcoma dissemination and response to T-cell therapy in mice assessed by whole-body magnetic resonance imaging.

BACKGROUND: Novel treatment strategies in Ewing sarcoma include targeted cellular therapies. Preclinical in vivo models are needed that reflect their activity against systemic (micro)metastatic disease. METHODS: Whole-body magnetic resonance imaging (WB-MRI) was used to monitor the engraftment and dissemination of human Ewing sarcoma xenografts in mice. In this model, we evaluated the therapeutic efficacy of T cells redirected against the Ewing sarcoma-associated antigen GD2 by chimeric receptor engineering. RESULTS: Of 18 mice receiving intravenous injections of VH-64 Ewing sarcoma cells, all developed disseminated tumour growth detectable by WB-MRI. All mice had lung tumours, and the majority had additional manifestations in the bone, soft tissues, and/or kidney. Sequential scans revealed in vivo growth of tumours. Diffusion-weighted whole-body imaging with background signal suppression effectively visualised Ewing sarcoma growth in extrapulmonary sites. Animals receiving GD2-targeted T-cell therapy had lower numbers of pulmonary tumours than controls, and the median volume of soft tissue tumours at first detection was lower, with a tumour growth delay over time. CONCLUSION: Magnetic resonance imaging reliably visualises disseminated Ewing sarcoma growth in mice. GD2-retargeted T cells can noticeably delay tumour growth and reduce pulmonary Ewing sarcoma manifestations in this aggressive disease model.

Diffusion Tensor Imaging of Dystrophic Skeletal Muscle : Comparison of Two Segmentation Methods Adapted to Chemical-shift-encoded Water-fat MRI.

PURPOSE: To compare the influence of two different regions of interest (ROIs) on diffusion tensor metrics in dystrophic thigh muscles using a custom-made (whole muscle) ROI including and a selective ROI excluding areas of fatty replacement. METHODS: Diffusion tensor imaging (DTI) and chemical-shift-encoded water-fat magnetic resonance imaging (MRI) of the thigh was conducted on a 3-Tesla system in 15 cases with muscular dystrophy and controls. The ROIs were chosen according to patterns of fatty replacement on co-registered axial DTI and gradient echo sequence (GRE) images. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), fiber track length (FTL), and muscle fat fractions (MFF) were compared between both ROI segmentations. These comparisons, muscle-specific correlation coefficients, and the influence of ROI localization on tensor metrics were derived based on linear mixed effects regression models. RESULTS: In the cases a high correlation was observed for ADC and FA with MFF using a custom ROI. The correlation was weaker but still significant with a selective ROI method. Using the custom ROI, FTL correlated significantly with MFF in 3 out of 4 muscles (r ≤ -0.51). A correlation was not found for the selective ROI method. Interaction analysis revealed that the association of ADC and FA with MFF was not significantly influenced by the ROI localization. For FTL the ROI localization significantly reduced the negative association with MFF. CONCLUSION: The DTI metrics and FTL of custom ROI segmentation are significantly influenced by MFF. Contrary to ADC and FA, the effect of MFF on FTL is significantly reduced when applying selective ROI segmentation, which could therefore be a better option for MR tractography.

Monitoring of gustatory stimulation of salivary glands by diffusion-weighted MR imaging: comparison of 1.5T and 3T.

BACKGROUND AND PURPOSE: Our aim was to compare different field strengths monitoring physiologic changes due to oral stimulation of parotid glands by using diffusion-weighted (DW) echo-planar imaging (EPI). MATERIALS AND METHODS: Twenty-seven healthy volunteers were examined with a DW-EPI sequence at 1.5T and 3T before and after oral stimulation with commercially available lemon juice. The b factors used were 0, 500, and 1000 s/mm(2). Apparent diffusion coefficient (ADC) maps were evaluated with a manually placed region of interest including the entire parotid gland. For comparison of results, a Student t test was used on the basis of the mean of the volunteer median values. To compare both field strengths, we calculated the Pearson correlation coefficient (r). RESULTS: DW-EPI MR imaging visualized the parotid glands of all volunteers. With 1.5T, the mean ADC before stimulation was 1.12 x 10(-3) mm(2)/s +/- 0.08 x 10(-3) mm(2)/s. After stimulation with lemon juice, the ADC increased to 1.18 x 10(-3) mm(2)/s +/- 0.09 x 10(-3) mm(2)/s. For 3T, the ADC before stimulation was 1.14 x 10(-3) mm(2)/s +/- 0.04 x 10(-3) mm(2)/s, with an increase to 1.17 x 10(-3) mm(2)/s +/- 0.05 x 10(-3) mm(2)/s after stimulation. For both field strengths, the increase in ADC after stimulation was significant (P < .001). High correlations between both field strengths were found pre- and poststimulation (r = 0.955, and 0.936, respectively). CONCLUSION: DW-EPI MR imaging allows monitoring of physiologic changes due to oral stimulation of parotid glands by using DW imaging with high correlation between 1.5T and 3T.

The use of a surgical sealant (CoSeal) in cardiac and vascular reconstructive surgery: an economic analysis.

AIM: We designed a study to estimate the economic impact of CoSeal Surgical Sealant for the prevention of anastomotic bleeding in cardiac and vascular surgery. We also explored the potential economic value of CoSeal as a means of inhibiting the formation of pericardial tissue adhesions. METHODS: A Delphi panel of 6 expert vascular and cardiac surgeons provided the assumptions and estimates needed to develop a decision analysis model to assess the impact of sealant on the costs associated with low- and high-risk forms of cardiac (valve replacement/reconstruction) and vascular (abdominal aortic aneurysm [AAA] repair, femoral bypass grafting) surgery. The primary outcome was incremental cost per patient. RESULTS: For valve repair/replacement surgery, sealant was expected to confer cost-savings in high-risk but not low-risk procedures. Predicted cost savings for high-risk AAA repairs were substantial, but minimal in the overall AAA group. Cost-savings were predicted for sealant use in all femoral-popliteal ePTFE bypass grafts, but in high-risk femoral-femoral ePTFE bypass grafts only. CONCLUSIONS: According to our decision analysis model, routine use of surgical sealant in select subgroups may confer considerable economic benefits to health service budgets. Future research should aim at testing this model in a real-world hospital setting. Assessment of the value of CoSeal in the prevention of postsurgical adhesions showed that expert surgeons see a need for effective prophylaxis. Further research into the clinical and economic benefit of this intervention is required.

5'-N-substituted carboxamidoadenosines as agonists for adenosine receptors.

Novel as well as known 5'-N-substituted carboxamidoadenosines were prepared via new routes that provided shorter reaction times and good yields. Binding affinities were determined for rat A1 and A2A receptors and human A3 receptors. EC50 values were determined for cyclic AMP production in CHO cells expressing human A2B receptors. On all receptor subtypes relatively small substituents on the carboxamido moiety were optimal. Selectivity for the A3 receptor was found for several analogues (1a, 1d, 1h, and 1k). On A1 receptors a number of compounds, but not 5'-N-ethylcarboxamidoadenosine (NECA, 1b), showed small GTP shifts, which could be indicative of lower intrinsic activities at the A1 receptor. At the A2B receptor, derivatives 1i-k with modified ethyl substituents had reduced activities compared to the A2B reference agonist NECA (1b). Thiocarboxamido derivatives (8b and 8c) displayed considerable although decreased A2B receptor activity. The X-ray structure determination of compound 8b was carried out. Due to intramolecular hydrogen bonding between the carboxamido NH and the purine N3 in the crystal structure, the ribose moiety of this compound is in a syn conformation. However, theoretical calculations support that NECA (1b), and less so 8b, can readily adopt both the syn and the anti conformation, therefore not excluding the proposed anti mode of binding to the receptor.

Characterization of poly(L-lactic acid) microspheres loaded with holmium acetylacetonate.

Holmium-loaded PLLA microspheres are useful systems in radioembolization therapy of liver metastases because of their low density, biodegradability and favourable radiation characteristics. Neutron activated Ho-loaded microspheres showed a surprisingly low release of the relatively small holmium complex. In this paper factors responsible for this behaviour are investigated, in particular by the use of differential scanning calorimetry, scanning electron microscopy, infrared spectroscopy and X-ray diffraction. The holmium complex is soluble in PLLA up to 8% in films and 17% in microspheres. Interactions between carbonyl groups of PLLA, and the Ho-ion in the HoAcAc complex, explain very satisfactorily the high stability of holmium-loaded microspheres.

Hydrogenation of

The course of the hydrogenation of [5]- and [6]metacyclophane (1b and 1c) and their thermochemistry is described. Both compounds are hydrogenated rapidly (within 10 s) to furnish the bridgehead olefins 13b and 12c. The accompanying hydrogenation enthalpies are -220 and -141 kJmol(-1), respectively. Strain energies (SE) and olefinic strains (OS) of a number of bridgehead olefins have been evaluated by DFT calculations; it was concluded that 13b belongs to the class of hyperstable olefins which correlates nicely with its reluctance to undergo hydrogenation. By combining experimental hydrogenation enthalpies and DFT calculations, SE of 187 and 121 kJmol(-1) were derived for 1b and 1c.

A multiple hydrogen-bond scaffold based on dipyrimidin-2-ylamine.

A multiple hydrogen-bond array based on dipyrimidin-2-ylamine is presented, which is easily accessible. The influence of a preorganizing intramolecular hydrogen bond, tautomeric equilibria, and steric effects on the association behavior were investigated. X-ray diffraction shows that the molecules feature an ADA (acceptor-donor-acceptor) array of hydrogen-bonding sites in the solid state. The array persists in solution, and (1)H NMR titrations show that molecules with sterically nondemanding DAD arrays are selectively bound. [structure: see text]

Liver iron quantification: studies in aqueous iron solutions, iron overloaded rats, and patients with hereditary hemochromatosis.

For the noninvasive liver iron quantification by MRI in human iron overload diseases, fundamental proton relaxation mechanisms were studied in aqueous solutions with ferritin and other iron compounds, in experimentally iron overloaded rats, and in patients with iron overload diseases. MR-relaxation rates as a function of iron concentrations in the range of 0-7.5 mg Fe/g aqueous iron solutions, 0-5.4 mg Fe/g rat liver in vivo, and 0.16-4.9 mg Fe/g human liver in vivo were determined from multi- and sets of single-spin echo sequences (1.5 T imager). As predicted by theory, transverse relaxation rates (1/T2) in aqueous iron solutions, in liver tissue of rats, and in human liver tissue increased linearly with the iron concentration. A preliminary calibration for the liver iron quantification by MRI was performed from in vivo measurements of liver 1/T2-relaxation rates and liver iron quantification by atomic absorption spectroscopy in biopsies from 13 patients. With the single spin-echo method, precise in vivo liver iron quantification in humans also above 2.0 mg Fe/g liver tissue (T2 < 15 ms) should be accomplished on any imager with shortest spin-echo time available, at least TE < 20 ms.

[Measurement of noise levels in MR tomography at 1.5 Tesla]. / Messungen zur Geräuschbelastung in der MR-Tomographie bei 1,5 Tesla.

The noise levels at the isocentrum of an MR apparatus with a field strength of 1.5 Tesla was measured during various sequences. The rapid switching of the gradients exerts effects on the gradient coils, which result in the development of noise as from a loudspeaker. Measurements were carried out using gradients of 3 and 9.3 mT/m with head and body coils and a variety of sequences. The noise level depended largely on the type of sequence and, under extreme conditions, may attain 96 dB. Because of the short exposure times, we do not consider it necessary to use any form of protection. During the examination of patients with damaged hearing, some protection may be advisable.

[Methodologic variants on rapid MR imaging of the liver]. / Methodische Variante zur schnellen MR-Bildgebung der Leber.

The development of rapid imaging methods makes it possible to obtain T1 and T2-weighted MR images in less than 15 seconds. Consequently images can be obtained without respiratory artefacts. An attempt has been made to obtain optimal factors for the fast-field-echo procedure in order to obtain satisfactory images of the liver with T1 and T2 sequences. By moving the examination couch, it is possible to obtain 10 mm transverse sections without gaps throughout the entire liver in a reasonable time. The additional use of contrast medium (Gd-DTPA) provides information about perfusion and leads to an increase in contrast between lesions and normal liver tissue with adequate image quality. The method is particularly valuable before surgery for liver metastases.

[High resolution contrast-enhanced 3D MR-angiography of renal arteries using parallel imaging (SENSE)]. / Hochauflösende Kontrastmittel-gestützte 3D-MR-Angiographie (MRA) der Nierenarterien mit paralleler Bildgebung (SENSE).

PURPOSE: To compare three dimensional contrast enhanced MR angiography with parallel imaging technique (sensitivity encoding) to standard MR angiography technique. MATERIAL AND METHODS: CE-3D MRA of renal arteries was performed in 22 patients (23 examinations) on a 1.5 T MR- scanner (Gyroscan Intera, Philips, Netherlands). For contrast enhanced MRA a single dose of Gd-DTPA (0.1 mmol/kg b.w.) was administered. Group I: The following standard 3D gradient echo (GE) sequence was performed in 9 of the 22 patients: TR: 4.3 ms, TE: 1.5 ms, flip angle: 40, 40 slices, scan duration: 19 seconds. A spatial resolution of 1.96 x 1.76 x 3.0 mm (3) (1.76 x 1.76 x 1.5 mm (3) interpolated) was obtained. Group II: 14 examinations were acquired in 13 patients: TR, TE and flip angle were equal compared to the first protocol. The k-space lines were acquired with CENTRA (contrast-enhanced time robust angiography) and parallel imaging technique (SENSE). 60 slices were acquired, scan duration was 24 seconds. The spatial resolution of this sequence was 1.19 x 1.08 x 2.0 mm (3) (0,84 x 0,84 x 1,0 mm (3) interpolated). Original images and calculated maximum intensity projection (MIP) images were analysed by two radiologists. Image quality and the visibility of renal arteries were rated on a four-point scale. RESULTS: In the first group the image quality was rated "good" in 8/9 patients. The renal arteries were detected in all cases and rated "good". The anterior and posterior segments were rated "good" in only 5/9 and the lobar arteries were detectable only in 3 of 9 cases. The interlobar arteries could not be seen in these patients. In the second group the image quality was rated excellent in 5 examinations and good in 9 of 14 examinations. The rating for the renal arteries was excellent in all examinations (14/14). The results of the anterior and posterior segment were as followed: excellent 5/14, good 7/14, insufficient 2/14; the lobar arteries: good 6/14, insufficient 6/14 and not detectable 2/14. Interlobar arteries could be seen in 7/14 examinations, but the quality was insufficient. In 7/14 the interlobar arteries could not be detected. CONCLUSION: The use of parallel imaging technique improves image quality and the delineation of small vessels in renal MRA.

[Magnetic resonance tomographic studies at 2.0 Tesla. Evaluation of clinically relevant parameters]. / Kernspintomographische Untersuchungen bei 2,0 Tesla. Wertung von klinisch relevanten Einflussgrössen.

After having used a 2 Tesla prototype whole body scanner for about one and a half years, it is now possible to comment on the clinical value of high field strengths. The methods and techniques employed are described. The problems arising from high field strengths are discussed and their effect on clinical diagnosis is indicated.

[Pulse triggering in magnetic resonance tomography in high-field strength]. / Pulstriggerung in der Magnetresonanztomographie bei höheren Feldstärken.

Gated images of patients with stronger pulsation artefacts in the brain stem were produced on a 1.5 tesla MR-imager, registering blood pulsations by means of a finger plethysmograph. A minimization of movement artefacts was achieved and thus sufficient diagnostic-value of images in these patients was noticeable. This gating method seems to be a promising simple alternative compared to the well known cardiac gating for imaging of the head and neck area. Its advantages and limitations are demonstrated.

[Cine-MRT for studying regional myocardial function]. / Cine-MRT zur Untersuchung der regionalen Myokardfunktion.

Cine-MRT was performed in 8 healthy subjects and in 16 patients with myocardial infarction, in whom regional wall motion abnormalities had been demonstrated by left ventricular angiography. Short axis and long axis slices were obtained by angulation of the imaging planes according to the orientation of the cardiac axes. From the end-diastolic and end-systolic images, systolic wall thickening and radial wall motion were determined. In healthy subjects, regional variation in wall thickening was not significant. Patients with myocardial infarction demonstrated abnormal wall motion within the infarct region. Discrepancies between wall thickening and wall motion were observed in 8 patients.

[Risks and artifacts in MRT (1.5 tesla) caused by metallic foreign bodies. Studies on phantoms and 60 patients]. / Risiken und Bildartefakte in der MRT (1,5 Tesla) durch metallische Fremdkörper. Untersuchungen an Phantomen und 60 Patienten.

Our experience of the effects of metallic foreign bodies on MRT high field examinations is described. In vitro measurements showed moderate magnetic torsion or displacement in a few cases. The findings in 60 patients with various metal foreign bodies and the resulting artifacts are discussed. Despite local loss of information, in the majority of cases there is additional evidence provided by MRT, which suffers less from foreign body artifacts than does CT. Stainless steel implants result in some signal loss and geometric distortion, but do not usually constitute a danger to the patient and do not affect the diagnostic information from surrounding structures.

[Measurement of CSF flow in the spinal canal using MRI with an optimized MRI protocol: experimental and clinical studies]. / MR-tomographische Liquorflussmessungen am Spinalkanal mit einem optimierten MRT-Protokoll: Experimentelle und klinische Untersuchungen.

PURPOSE: Measurement of the oscillating CSF flow in the spinal canal (SC) of healthy volunteers and in patients with post-traumatic syringomyelia (PTS) using an optimized MRI protocol as well as to determine whether stenosis induced velocity changes are detectable using MRI. METHODS: In 68 healthy volunteers quantitative studies of CSF flow in the cervical, thoracic, and lumbar regions were performed. First, an optimized sequence was developed and tested in 19 volunteers using four different flow-encoding velocities (4, 8, 12, 16 cm/s). Secondly, the optimized sequence was employed in 49 volunteers to measure the different CSF patterns in the cervical, thoracic, and lumbar spinal canals (CSC, TSC, LSC). Part three of the study, in which patients with PTS are being examined is still underway. We measured the maximum velocity (cm/s), the pixel area (mm2), and the stroke volume (ml/s). Using a flow model the velocities prior to and after compression with 5 different power levels were measured at the stenosis and at a distance of 70 cm. RESULTS: A total of 226 dynamic measurements have been performed--so far 76 in the first part (62 = 81.5% evaluable) and 150 in the second part--using the optimized sequence and optimal flow velocities. A flow-encoding sequence of 12 cm/s was found best in the CSC and one of 6 cm/s in the TSC and LSC. The maximum velocity in the CSC was 0.95 cm/s with the flow being directed caudal and 0.38 cm/s with the flow being directed cranial. In the TSC the values were 4.7 cm/s and 1.65 cm/s and in the LSC 0.96 cm/s and 0.59 cm/s. The highest velocities were found at the TSC, which has the smallest diameter compared to the CSC and LSC. In the 4 patients with PTS, the maximum velocities were between 0.09 cm/s and 0.97 cm/s with the flow being directed cranial and between 0.04 cm/s and 1.03 cm/s with the flow being directed caudal. The stroke volumina in the CSC were between 0.1 and 1.23 ml/s (mean: 0.48 ml/s) and 0.2 and 2.45 ml/s (mean: 0.66 ml/s) in the TSC and in the LSC 0.08 ml/s and 0.67 ml/s (mean: 0.29 ml/s). The results of the flow model studies showed an increase of velocity between 2.06 and 4.94 cm/s (mean: 3.31 cm/s) at the stenosis and 1.1 and 1.33 cm/s (mean: 1.23 cm/s) at a distance of 70 cm. CONCLUSION: Quantitative measurement of the oscillating CSF flow in the entire spinal canal (SC) is possible using an optimized MRI protocol as well as to detect stenosis induced velocity changes. Due to the high interindividual variability in the data of spinal CSF dynamics, further studies are necessary to collect normal data. The detection of movement of CSF in a post-traumatic spinal cord lesion may alter the therapeutic management.