AIM: This study was designed to determine the hemodynamics of cerebrospinal fluid flow in syringomyelia patients associated with Chiari I malformation using phase-contrast velocity-encoded-cine MRI and also to find out whether treatment outcomes may be predicted by these flow measurements.

MATERIAL and METHODS: Eighteen consecutive symptomatic patients with syringomyelia associated with Chiari 1 malformation were included. The PC VEC MRI was performed at the level of foramen magnum and syrinx cavity both preoperatively and 6 months postoperatively. Following surgery, the modified Asgari score was calculated, and the association between CSF flow pattern and clinical outcome was assessed.

RESULTS: Evaluation of clinical symptoms at postoperative 6th month revealed improvement in 11 (61%) patients and stabilization in 5 (28%) patients whereas results were poor in 2 (11%) patients. Preoperative cine MRI flow studies showed a heterogeneous pattern at the foramen magnum level in all of the patients. Postoperative cine MR flow studies demonstrated the change from heterogeneous pattern to sinusoidal pattern in 11 patients and a decrease in heterogenity in 7 patients.

CONCLUSION: Our results indicate that CSF flow measurements using PC VEC MRI can give important information regarding the prognosis and follow-up of the patients with Chiari I malformation.