A mathematical model for predicting intracranial pressure based on noninvasively acquired PC-MRI parameters in communicating hydrocephalus.

To develop and validate a mathematical model for predicting intracranial pressure (ICP) noninvasively using phase-contrast cine MRI (PC-MRI). We performed a retrospective analysis of PC-MRI from patients with communicating hydrocephalus (n = 138). The patients were recruited from Shenzhen Second People's Hospital between November 2017 and April 2020, and randomly allocated into training (n = 97) and independent validation (n = 41) groups. All participants underwent lumbar puncture and PC-MRI in order to evaluate ICP and cerebrospinal fluid (CSF) parameters (i.e., aqueduct diameter and flow velocity), respectively. A novel ICP-predicting model was then developed based on the nonlinear relationships between the CSF parameters, using the Levenberg-Marquardt and general global optimisation methods. There was no significant difference in baseline demographic characteristics between the training and independent validation groups. The accuracy of the model for predicting ICP was 0.899 in the training cohort (n = 97) and 0.861 in the independent validation cohort (n = 41). We obtained an ICP-predicting model that showed excellent performance in the noninvasive diagnosis of clinically significant communicating hydrocephalus.