ّThe above question is based on my observation. I am looking for observations of other clinicians.
Given the success of Diffusion MRI in brain imaging, I think DMRI and/or DTI could give an incredible backing to your observation. These methods could also help explain the reasons for the differences.
Hello Michael. Thanks too much for this very important and interesting answer.
1) am not a radiologist or a physicist. Can you kindly give me an explanatory summary for the above answer.
2) On my search for DMRI I found the following paper:J Neurol Neurosurg Psychiatry 2003;74:1693-1696 doi:10.1136/jnnp.74.12.1693. It was on 2003 and it concludes:
"MR parameters in the two groups suggests that diffuse brain oedema is not a feature of IIH."
I do not agree as I feel that I feel that a balanced well calculated safe siphoning is an important therapeutic tool in IIH. What are your results?
3) Do you think that DMRI can be a good indicator of the correct balance point between under drainage and over drainage confidently in shunted patients? Or any other modality?
Many thanks and my best regards
Hi Dr. Omer Elsabbagh,
1. I would have loved to give you some explanations but as a physicist, I am afraid of bothering you with too much physics (General and MRI physics). Therefore, I think a nice introduction to the basics of DMRI and DTI could be found at: https://en.wikipedia.org/wiki/Diffusion_MRI
2. I am not into experimental MRI and I feel I may not be able to confirm the important issue you have rightly observed. I am familiar with the works of three scientists in these area and they may be of a great help to your research. (a) Denis Le Bihan [http://www.meteoreservice.com/dlb.htm] (b) Peter Basser [https://neuroscience.nih.gov/Faculty/Profile/peter-basser.aspx, https://irp.nih.gov/pi/peter-basser] (c) Roland Bammer [https://med.stanford.edu/profiles/roland-bammer]
3. I think DMRI can be a good indicator of the correct balance point between under drainage and over drainage. The intracranial fluid is an excellent source of protons which resonate to give off MR signals. The signal contains information on the fluid, flow/diffusion and every restriction the fluid molecules encounter.
I hope these help.
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