{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T19:20:47Z","timestamp":1778613647378,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH","award":["RF1AG076692"],"award-info":[{"award-number":["RF1AG076692"]}]},{"name":"NIH","award":["35938"],"award-info":[{"award-number":["35938"]}]},{"name":"Canon Medical Systems, Japan","award":["RF1AG076692"],"award-info":[{"award-number":["RF1AG076692"]}]},{"name":"Canon Medical Systems, Japan","award":["35938"],"award-info":[{"award-number":["35938"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Intrinsic cerebrospinal fluid (CSF) dynamics in the brain have been extensively studied, particularly the egress sites of tagged intrinsic CSF in the meninges. Although spinal CSF recirculates within the central nervous system (CNS), we hypothesized that CSF outflows from the lumbar spinal canal. We aimed to visualize and semi-quantify the outflow using non-contrast MRI techniques. We utilized a 3 Tesla clinical MRI with a 16-channel spine coil, employing time\u2013spatial labeling inversion (Time-SLIP) with tag-on and tag-off acquisitions, T2-weighted coronal 2D fluid-attenuated inversion recovery (FLAIR) and T2-weighted coronal 3D centric ky-kz single-shot FSE (cSSFSE). Images were acquired using time\u2013spatial labeling inversion pulse (Time-SLIP) with tag-on and tag-off acquisitions with varying TI periods. Ten healthy volunteers with no known spinal diseases participated. Variations in tagged CSF outflow were observed across different thoracolumbar nerve root segments in all participants. We quantified CSF outflow at all lumbar levels and the psoas region. There was no significant difference among the ROIs for signal intensity. The tagged CSF outflow from the spinal canal is small but demonstrates egress to surrounding tissues. This finding may pave the way for exploring intrathecal drug delivery, understanding of CSF-related pathologies and its potential as a biomarker for peripheral neuropathy and radiculopathy.<\/jats:p>","DOI":"10.3390\/bioengineering11070708","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T08:47:41Z","timestamp":1720774061000},"page":"708","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Visualization of Cerebrospinal Fluid Outflow and Egress along the Nerve Roots of the Lumbar Spine"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8291-7610","authenticated-orcid":false,"given":"Diana","family":"Vucevic","sequence":"first","affiliation":[{"name":"Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vadim","family":"Malis","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2616-0339","authenticated-orcid":false,"given":"Won C.","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA"},{"name":"Department of Radiology, VA San Diego Healthcare System, San Diego, CA 92161, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-3152","authenticated-orcid":false,"given":"Hideki","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tohoku University, Sendai 980-8576, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Oshio","sequence":"additional","affiliation":[{"name":"Department of Radiology, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marin A.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5690-694X","authenticated-orcid":false,"given":"Mitsue","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1148\/radiology.183.2.1561340","article-title":"Flow dynamics of cerebrospinal fluid: Assessment with phase-contrast velocity MR imaging performed with retrospective cardiac gating","volume":"183","author":"Nitz","year":"1992","journal-title":"Radiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1148\/radiology.185.3.1438741","article-title":"Brain motion: Measurement with phase-contrast MR imaging","volume":"185","author":"Enzmann","year":"1992","journal-title":"Radiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12987-019-0163-4","article-title":"Extracranial versus intracranial hydro-hemodynamics during aging: A PC-MRI pilot cross-sectional study","volume":"17","author":"Lokossou","year":"2020","journal-title":"Fluids Barriers CNS"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1148\/radiol.2492071985","article-title":"MRI visualization of cerebrospinal fluid movement with spin labeling: Preliminary results in normal and pathophysiological conditions","volume":"249","author":"Yamada","year":"2008","journal-title":"Radiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/2045-8118-10-36","article-title":"Influence of respiration on cerebrospinal fluid movement using magnetic resonance spin labeling","volume":"10","author":"Yamada","year":"2013","journal-title":"Fluids Barriers CNS"},{"key":"ref_6","first-page":"406","article-title":"Current and emerging MR Imaging techniques for the diagnosis and management of CSF flow disorders: A review of Phase-Contrast and Time\u2013Spatial Labeling Inversion Pulse","volume":"35","author":"Yamada","year":"2014","journal-title":"ANJR"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/2045-8118-11-10","article-title":"A new look at cerebrospinal fluid circulation","volume":"11","author":"Brinker","year":"2014","journal-title":"Fluids Barriers CNS"},{"key":"ref_8","first-page":"54","article-title":"Cerebrospinal fluid stasis and its clinical significance","volume":"15","author":"Whedon","year":"2009","journal-title":"Altern. 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