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To estimate various CSF motions in the entire intracranial region, we attempted to integrate the flow parameters calculated using the two MRI sequences. To elucidate how CSF dynamics deteriorate in Hakim\u2019s disease, an age-dependent chronic hydrocephalus, flow parameters were estimated from the two MRI sequences to assess CSF motion in the entire intracranial region.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study included 127 healthy volunteers aged\u2009\u2265\u200920\u00a0years and 44 patients with Hakim\u2019s disease. On 4D flow MRI for measuring CSF motion, velocity encoding was set at 5\u00a0cm\/s. For the IVIM MRI analysis, the diffusion-weighted sequence was set at six b-values (i.e., 0, 50, 100, 250, 500, and 1000\u00a0s\/mm<jats:sup>2<\/jats:sup>), and the biexponential IVIM fitting method was adapted. The relationships between the fraction of incoherent perfusion (<jats:italic>f<\/jats:italic>) on IVIM MRI and 4D flow MRI parameters including velocity amplitude (VA), absolute maximum velocity, stroke volume, net flow volume, and reverse flow rate were comprehensively evaluated in seven locations in the ventricles and subarachnoid spaces. Furthermore, we developed a new parameter for fluid oscillation, the Fluid Oscillation Index (FOI), by integrating these two measurements. In addition, we investigated the relationship between the measurements and indices specific to Hakim\u2019s disease and the FOIs in the entire intracranial space.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The VA on 4D flow MRI was significantly associated with the mean <jats:italic>f<\/jats:italic>-values on IVIM MRI. Therefore, we estimated VA that could not be directly measured on 4D flow MRI from the mean <jats:italic>f<\/jats:italic>-values on IVIM MRI in the intracranial CSF space, using the following formula; <jats:italic>e<\/jats:italic><jats:sup>0.2(<jats:italic>f<\/jats:italic>\u221285)<\/jats:sup>\u2009+\u20090.25. To quantify fluid oscillation using one integrated parameter with weighting, FOI was calculated as VA\u2009\u00d7\u200910\u2009+\u2009<jats:italic>f<\/jats:italic>\u2009\u00d7\u20090.02. In addition, the FOIs at the left foramen of Luschka had the strongest correlations with the Evans index (Pearson\u2019s correlation coefficient: 0.78). The other indices related with Hakim\u2019s disease were significantly associated with the FOIs at the cerebral aqueduct and bilateral foramina of Luschka. FOI at the cerebral aqueduct was also elevated in healthy controls aged\u2009\u2265\u200960\u00a0years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We estimated pulsatile CSF movements in the entire intracranial CSF space in healthy individuals and patients with Hakim\u2019s disease using FOI integrating VA from 4D flow MRI and <jats:italic>f<\/jats:italic>-values from IVIM MRI. FOI is useful for quantifying the CSF oscillation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12987-024-00552-6","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T10:18:44Z","timestamp":1717064324000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Modeling cerebrospinal fluid dynamics across the entire intracranial space through integration of four-dimensional flow and intravoxel incoherent motion magnetic resonance imaging"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-5569","authenticated-orcid":false,"given":"Shigeki","family":"Yamada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Otani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chifumi","family":"Iseki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoki","family":"Tanikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeo","family":"Wada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Oshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhito","family":"Mase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"issue":"3","key":"552_CR1","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1016\/j.neuron.2014.06.022","volume":"83","author":"S Ohata","year":"2014","unstructured":"Ohata S, Nakatani J, Herranz-Perez V, Cheng J, Belinson H, Inubushi T, et al. 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Healthy volunteers underwent MRI after providing written informed consent, and we particularly explained the potential for detecting diseases in the brain. The patients\u2019 MRI data were obtained using an opt-out method. All MRI data were extracted after the personal information of the study subjects was anonymized in a linkable manner. The study design was prospective and observational. This study was conducted according to the approved guidelines of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Some authors of this manuscript declare their relationship with FUJIFILM Corporation because this study used a SYNAPSE 3D workstation (FUJIFILM Corporation; Tokyo, Japan), as a medical device approved by the Pharmaceuticals and Medical Devices Agency of Japan in 2020. Shigeki Yamada has received research grants from the FUJIFILM Corporation and speakers\u2019 honoraria from FUJIFILM Medical Systems since 2019. Hirotaka Ito is employed by the FUJIFILM Corporation and has made substantial contributions to the development of the applications of the SYNAPSE 3D workstation. The other authors of this manuscript declare that they have no relationships with any companies whose products or services may be related to the subject matter of the article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"47"}}