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Studies in recent years have explored the diagnostic and prognostic value of PC-MRI derived parameters. This review aims to identify all PC-MRI studies of iNPH published since 2010, synthesise a review based on collated results, and analyse specific flow parameters identified in the selected studies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Our protocol was prospectively registered on PROSPERO [CRD42020180826]. We systematically searched four databases: Pubmed, Web of Science, Ovid, and Cochrane library to identify all eligible studies. Quality assessment was performed using a modified Newcastle\u2013Ottawa Scale [19]. Systematic review was conducted according to Prisma guidelines. A random-effects model was used to perform meta-analysis on the available flow parameters.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Eighteen records were identified for inclusion. Five studies were eligible for meta-analysis, representing 107 iNPH patients and 82 controls. CSF flow parameters available for analysis were stroke volume and peak velocity. Both were significantly higher than controls (p\u2009=\u20090.0007 and p\u2009=\u20090.0045 respectively) according to our random-effects analysis, consistent with a model of hyper-dynamic CSF in iNPH. Our systematic review revealed average stroke volumes in iNPH ranging from 43uL to over 200uL. Peak velocity values ranged from 5.9\u00a0cm\/s to 12.8\u00a0cm\/s.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Significant increases in stroke volume and peak velocity values in iNPH patients suggest a place for PC-MRI as supplementary evidence in the diagnostic work-up of iNPH. Although shunting reduces aqueductal stroke volume and peak velocity, the ability of pre-shunt values to reliably predict treatment response remains complicated. We suggest that it may be more appropriate to consider a range of values that reflect varying probabilities of shunt success. We recommend that future studies should prioritise standardising PC-MRI protocols, and before then PC-MRI findings should be considered supportive rather than determinative.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00701-024-06333-2","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T08:08:30Z","timestamp":1732003710000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Volumes and velocities: Meta-analysis of PC-MRI studies in normal pressure hydrocephalus"],"prefix":"10.1007","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2798-296X","authenticated-orcid":false,"given":"Helen","family":"Whitley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7764-7254","authenticated-orcid":false,"given":"Petr","family":"Skalick\u00fd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awista","family":"Zazay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4532-9219","authenticated-orcid":false,"given":"Ad\u00e9la","family":"Buben\u00edkov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4364-5522","authenticated-orcid":false,"given":"Ondrej","family":"Brad\u00e1\u010d","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"issue":"2","key":"6333_CR1","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.acra.2009.08.011","volume":"17","author":"O Algin","year":"2010","unstructured":"Algin O, Hakyemez B, Parlak M (2010) The efficiency of PC-MRI in diagnosis of normal pressure hydrocephalus and prediction of shunt response. 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