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      Noninvasive MRI assessment of intracranial compliance in idiopathic normal pressure hydrocephalus.

      Journal of Magnetic Resonance Imaging
      Adult, Aged, Aged, 80 and over, Biomechanical Phenomena, Brain, pathology, Case-Control Studies, Female, Humans, Hydrocephalus, Normal Pressure, diagnosis, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, methods, Male, Middle Aged, Reference Values, Reproducibility of Results

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          To assess the state and dynamics of the intracranial system in idiopathic normal-pressure hydrocephalus (I-NPH), we determined intracranial compliance using magnetic resonance imaging (MRI). The intracranial compliance index (ICCI), which was defined as the ratio of the peak-to-peak intracranial volume change (ICVC(p-p)) to the peak-to-peak cerebrospinal fluid (CSF) pressure gradient (PG(p-p)) during the cardiac cycle, was obtained from the net transcranial blood and CSF flow measured with phase-contrast (PC) cine MRI. ICCI was determined in patients with I-NPH (N = 7), brain atrophy, or asymptomatic ventricular dilation (VD) (N = 6), and in healthy volunteers (control group; N = 11). The changes in ICCI indices were also analyzed after a CSF tap test (N = 2). The ICCI in the I-NPH group was significantly lower than in the control and VD groups, whereas no difference was found between the control and VD groups. The ICVC(p-p) was also lower than in the control and VD groups. However, no significant difference was found in the PG(p-p) between groups. The ICCI increased after the tap test. Intracranial compliance analysis with MRI makes it possible to noninvasively obtain more detailed information of intracranial biomechanics in the I-NPH and to assist in the diagnosis of I-NPH. (c) 2007 Wiley-Liss, Inc.

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