This study was designed to determine the hemodynamics of cerebrospinal fluid flow in syringomyelia patients associated with Chiari I malformation using phase-contrast velocity-encoded-cine MRI and also to find out whether treatment outcomes may be predicted by these flow measurements.
Eighteen consecutive symptomatic patients with syringomyelia associated with Chiari 1 malformation were included. The PC VEC MRI was performed at the level of foramen magnum and syrinx cavity both preoperatively and 6 months postoperatively. Following surgery, the modified Asgari score was calculated, and the association between CSF flow pattern and clinical outcome was assessed.
Evaluation of clinical symptoms at postoperative 6th month revealed improvement in 11 (61%) patients and stabilization in 5 (28%) patients whereas results were poor in 2 (11%) patients. Preoperative cine MRI flow studies showed a heterogeneous pattern at the foramen magnum level in all of the patients. Postoperative cine MR flow studies demonstrated the change from heterogeneous pattern to sinusoidal pattern in 11 patients and a decrease in heterogeneity in 7 patients.
Our results indicate that CSF flow measurements using PC VEC MRI can give important information regarding the prognosis and follow-up of the patients with Chiari I malformation.