To trigger CSF flow studies, both ECG and peripheral pulse sensor can be used. ECG triggering is more precise, but derivation of an adequate ECG signal can be difficult in some patients at MRI. In such cases peripheral gating by a pulse sensor represents a suitable alternative. Prospective ECG triggering includes the disadvantage of a partial data loss at diastole because the end of the cardiac cycle is not exactly defined and has to be determined prospectively. At retrospective gating, cardiac cycle and CSF pulsation are recorded separately and the required data subsequently divided into the cardiac cycle. So retrospective gating prevents data loss and is more suitable for daily practise.

In principle, spinal CSF flow studies can be realised at all MRI with the usual magnetic field strengths between 1.0 and 3 T by using a spine coil. To ensure a strictly sagittal position of the CSF flow study in the middle of the spinal canal, additional coronal T2 weighted sequences should be performed for measurement planning. To receive an adequate flow signal and to avoid aliasing, a suitable maximum flow velocity (Vmax) has to be chosen. Common settings are values of Vmax between 3 and 8 cm/s. For examinations of the cervical spine it is advisable to start with a Vmax of 8 cm/s. Examinations of the dorsal spine should be started with a Vmax of 5 cm/s. In cases of aliasing the CSF flow study should be repeated with a higher Vmax of 8 cm/s. If the flow signal is too low, sensitivity of CSF flow study has to be increased by lowering the Vmax. Depending on the software, some MRI scanners enable axial CSF flow studies with the possibility of automated quantitative analysis of flow velocity by using region of interest measurements.