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Hemodynamically self-corrected δadc analysis in idiopathic normal pressure hydrocephalus.

OBJECTIVE:: To clarify the cause of higher water fluctuation of the brain in idiopathic normal pressure hydrocephalus (iNPH), we assessed change in hemodynamic-independent apparent diffusion coefficient during the cardiac cycle (ΔADC) in iNPH.

METHODS:: Electrocardiographically synchronized single-shot diffusion echo-planer (b = 0, 500, and 1000  s/mm2 ) was performed in healthy volunteers, atrophic ventricular dilation group, and iNPH group, respectively. The ΔADC (b = 0  and 1000  s/mm2 ) and maximum ADC (b = 0  and 500  s/mm2 ) in the cardiac cycles were measured at the frontal white matter in the brain. Then, self-corrected ΔADC was obtained from the ΔADC divided by the maximum ADC (ADCpeak : perfusion-related diffusion) to correct the blood flow effect.

RESULTS:: The ΔADC after correction was significantly higher in the iNPH group than in the other two groups. However, there was no significant difference in ADCpeak values among the groups.

CONCLUSIONS:: Self-corrected ΔADC in iNPH increased because of changes in the biomechanical properties of the brain. Self-corrected ΔADC analysis makes it possible to obtain information on hemodynamically independent water fluctuation as well as perfusion in iNPH.

ADVANCES IN KNOWLEDGE:: Analysis self-corrected ΔADC provides simultaneously information on biomechanical properties, perfusion, and water fluctuation in iNPH.

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