TY - JOUR
T1 - Lumbosacral cerebrospinal fluid volume in humans using three-dimensional magnetic resonance imaging
AU - Sullivan, John
AU - Grouper, Sharon
AU - Walker, Matthew T.
AU - Parrish, Todd B
AU - McCarthy, Robert J
AU - Wong, Cynthia A.
PY - 2006/11/1
Y1 - 2006/11/1
N2 - BACKGROUND: The clinical response to spinal anesthesia is influenced by lumbosacral cerebrospinal fluid (CSF) volume, which is highly variable among patients. METHODS: Lumbosacral magnetic resonance images were obtained in 71 patients using a long echo time (TE = 198 msec), fast spin echo sequence with fat suppression. Three-dimensional images were created and lumbosacral CSF volume was estimated using a threshold-based region growing algorithm. RESULTS: A validation experiment using a water bath and cadaveric spinal cord demonstrated that the technique was accurate (1.4 ± 0.4% difference between estimated and measured). The coefficient of variance was 0.42% among the three estimated CSF values per subject. The mean calculated volume was 35.8 ± 10.9 mL with a range of 10.6-61.3 mL. Lumbosacral CSF volume was widely variable among patients and was inversely proportional to body mass index (r = -.276, P = 0.02). Mean calculated lumbosacral CSF volumes were smaller in the group of subjects that had radiographic diagnoses of spinal stenosis when compared with subjects with no diagnosis (mean difference -8.4 mL, 95% CI of the difference, -16.1 to -0.8 mL, P = 0.03) and were not different when compared with those with herniated disk disease (mean difference -6.4 mL, 95% CI of the difference -14.7 to 1.9 mL, P = 0.19). CONCLUSIONS: Application of this technique to clinical investigations may further enhance our understanding of spinal anesthesia.
AB - BACKGROUND: The clinical response to spinal anesthesia is influenced by lumbosacral cerebrospinal fluid (CSF) volume, which is highly variable among patients. METHODS: Lumbosacral magnetic resonance images were obtained in 71 patients using a long echo time (TE = 198 msec), fast spin echo sequence with fat suppression. Three-dimensional images were created and lumbosacral CSF volume was estimated using a threshold-based region growing algorithm. RESULTS: A validation experiment using a water bath and cadaveric spinal cord demonstrated that the technique was accurate (1.4 ± 0.4% difference between estimated and measured). The coefficient of variance was 0.42% among the three estimated CSF values per subject. The mean calculated volume was 35.8 ± 10.9 mL with a range of 10.6-61.3 mL. Lumbosacral CSF volume was widely variable among patients and was inversely proportional to body mass index (r = -.276, P = 0.02). Mean calculated lumbosacral CSF volumes were smaller in the group of subjects that had radiographic diagnoses of spinal stenosis when compared with subjects with no diagnosis (mean difference -8.4 mL, 95% CI of the difference, -16.1 to -0.8 mL, P = 0.03) and were not different when compared with those with herniated disk disease (mean difference -6.4 mL, 95% CI of the difference -14.7 to 1.9 mL, P = 0.19). CONCLUSIONS: Application of this technique to clinical investigations may further enhance our understanding of spinal anesthesia.
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U2 - 10.1213/01.ane.0000240886.55044.47
DO - 10.1213/01.ane.0000240886.55044.47
M3 - Article
C2 - 17056974
AN - SCOPUS:33750318675
VL - 103
SP - 1306
EP - 1310
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 5
ER -