Flow MRI in Normal Pressure Hydrocephalus

Study Overview
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Brief Summary
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Normal pressure hydrocephalus diagnosis based on quantitative study of cerebro-spinal fluid and blood flow by phase contrast magnetic resonance imaging.

Official Title
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Benefit of Flow Magnetic Resonance Imaging in the Management of Normal Pressure Hydrocephalus

Conditions
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Normal Pressure Hydrocephalus

Intervention / Treatment
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* Other: Flow imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ventricular dilation seen on morphological magnetic resonance imaging (MRI) Walking disorder Cognitive disorder Participants gave their written informed consent Exclusion Criteria: Contra-indication to MRI Obstructive tumoral hydrocephalus Curatorship or tutorship Pregnancy or lactation No social assurance

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Surgery<br>Patients who will undergo flow imaging and neurosurgery (shunting). (25% of the studied population) | Other: Flow imaging<br>* Quantitative flow study was performed by 2D phase-contrast velocity-encoded cine MRI (repetition/echo time, 15/7 ms; field of view = 140 x 140 mm²; matrix size = 256 x 128, flip angle = 25 degrees,one excitation, slice thickness = 5 mm). Cerebrospinal fluid and blood flows are measured with a velocity-encoding value of 5-10 cm/s and 80 cm/s respectively. Peripheral gating was used to cover the entire cardiac cycle with retrospective cardiac synchronization of 32 quantitative flow-encoded images per cycle. Clinical examination consists in Larson's score and MMSE<br>* Other names: Cerebral blood flow;|
| Experimental: Clinical follow-up<br>Patients who will undergo flow imaging but not surgery (75% of the studied population) | Other: Flow imaging<br>* Quantitative flow study was performed by 2D phase-contrast velocity-encoded cine MRI (repetition/echo time, 15/7 ms; field of view = 140 x 140 mm²; matrix size = 256 x 128, flip angle = 25 degrees,one excitation, slice thickness = 5 mm). Cerebrospinal fluid and blood flows are measured with a velocity-encoding value of 5-10 cm/s and 80 cm/s respectively. Peripheral gating was used to cover the entire cardiac cycle with retrospective cardiac synchronization of 32 quantitative flow-encoded images per cycle. Clinical examination consists in Larson's score and MMSE<br>* Other names: Cerebral blood flow;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cerebrospinal fluid (CSF) stroke volume evolution other 6 months | Measurement of cerebrospinal fluid (CSF) stroke volume via flow MRI at the Sylvius' aqueduct, pontine cistern and spinal spaces levels and determination of its evolution | Day 1 (baseline), Day 180 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood flow analysis : evolution other 6 months | Assessment of arterial (internal carotids and cerebral arteries) and venous (sagittal sinus, straight sinus) blood flow in terms of mean cerebral blood outflow and stroke volume and determination of blood flow evolution. | Day 1 (baseline), Day 180 | 
| Larson's score evolution over 6 months | Record symptoms on walking, living conditions and urinary disorders | Day 1, Day 180 | 
| Neuropsychological test evolution over 6 months | Consists in mini mental status evaluation (MMSE) for cognitive evaluation | Day1, Day 180 | 
| Blood flow analysis : evolution other one year | Assessment of arterial (internal carotids and cerebral arteries) and venous (sagittal sinus, straight sinus) blood flow in terms of mean cerebral blood outflow and stroke volume and determination of blood flow evolution. | Day 1 (baseline) and Day 365 | 
| Larson's score evolution over one year | Record symptoms on walking, living conditions and urinary disorders | Day 1 and Day 365 | 
| Neuropsychological test evolution over one year | Consists in mini mental status evaluation (MMSE) for cognitive evaluation | Day1, Day 365 | 
| cerebrospinal fluid (CSF) stroke volume evolution other one year | Measurement of cerebrospinal fluid (CSF) stroke volume via flow MRI at the Sylvius' aqueduct, pontine cistern and spinal spaces levels and determination of its evolution | Day1 (baseline), Day 365 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Normal pressure hydrocephalus, Flow MRI, Dementia, Cerebrospinal fluid, Shunt