In vitro evaluation of cerebrospinal fluid velocity measurement in type I Chiari malformation: repeatability, reproducibility, and agreement using 2D phase contrast and 4D flow MRI

Abstract Background Phase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice Chiari malformation diagnostics. To improve these diagnostic practices, better understanding MRI based measurement agreement, repeatability, and reproducibility dynamics needed. Methods An anatomically realistic vitro subject specific model patient was scanned three times at five different scanning centers using 2D 4D Flow techniques to quantify intra-scanner inter-scanner reproducibility, agreement between imaging modalities. Peak systolic velocities were measured nine axial planes which then compared peak velocity measurements extracted those exact positions along the model. Results Comparison results showed good overall detection (p = 0.86), fair repeatability (confidence intervals ± 1.5 cm/s), poor reproducibility. On average, had larger variability than (standard deviations 1.83 1.04 cm/s, respectively). Conclusion Agreement, quantified patient-specific malformation. In combination, greatest factor leading inconsistency determined be lack centers. Overall, findings may help lead application as tools related diseases.