{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:21:56Z","timestamp":1781151716107,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The causative mechanisms of idiopathic normal\u2010pressure hydrocephalus (iNPH) symptoms are currently unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess the dynamic changes in the apparent diffusion coefficient (ADC) during the cardiac cycle (\u0394ADC) of the brain before and after the lumbar tap and shunt surgery for the purpose of determining changes in hydrodynamic and biomechanical properties in the brain after cerebrospinal fluid (CSF) drainage for iNPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Overall, 22 patients suspected to have iNPH were examined before and after the lumbar tap and were divided into patients who showed symptomatic improvements (positive group, <jats:italic>n =<\/jats:italic> 17) and those without improvement (negative group, <jats:italic>n =<\/jats:italic> 5) after the lumbar tap. Seven patients in the positive group were examined after the shunt surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5T, electrocardiographically synchronized single\u2010shot diffusion echo\u2010planar imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>The frontal white matter \u0394ADC and mean ADC (ADC<jats:sub>mean<\/jats:sub>) were compared between before and 24\u2009hours after lumbar tap and from 1\u2009week to 1\u2009month after the shunt surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Wilcoxon signed\u2010rank test was used. <jats:italic>P<\/jats:italic> &lt;\u20090.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The \u0394ADC after the lumbar tap in the positive group was significantly lower than that before (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), whereas no significant difference was found in the negative group (<jats:italic>P<\/jats:italic> = 0.23). After the lumbar tap, \u0394ADC decreased in 16 of 17 patients in the positive group, whereas ADC<jats:sub>mean<\/jats:sub> did not significantly change (<jats:italic>P<\/jats:italic> = 0.96). After the shunt surgery, \u0394ADC decreased in all seven patients (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), whereas ADC<jats:sub>mean<\/jats:sub> did not significantly change (<jats:italic>P<\/jats:italic> = 0.87).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>The frontal white matter \u0394ADC in iNPH decreased after the lumbar tap and shunt surgery. \u0394ADC analysis may provide detailed information regarding changes in the hydrodynamic and biomechanical properties through CSF drainage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy Stage<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27412","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T11:48:55Z","timestamp":1603885735000},"page":"1200-1207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Changes in Apparent Diffusion Coefficient (<scp>ADC)<\/scp> during Cardiac Cycle of the Brain in Idiopathic Normal Pressure Hydrocephalus Before and After Cerebrospinal Fluid Drainage"],"prefix":"10.1002","volume":"53","author":[{"given":"Tomoshi","family":"Osawa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7720-8040","authenticated-orcid":false,"given":"Naoki","family":"Ohno","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, 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