title: Tracer clearance in radionuclide cisternography in patients with spontaneous intracranial hypotension.
abstract: We semiquantitatively analysed radionuclide cisternography in three patients with spontaneous cerebrospinal fluid (CSF) leakage diagnosed by typical symptoms and magnetic resonance imaging findings before and several months after treatment with epidural blood patch. Radioactivity in the whole CSF space was measured immediately after and at 1, 5, 7 and 24 h after intrathecal injection of (111)In-diethylenetriaminepentaacetic acid (DTPA). Initial findings included the vague appearance of leakage in the thoracic spine in two patients, early bladder filling at 1 h in one and a lack of tracer filling into the high cranial convexity in all three. The radioactivity count rapidly decreased within several hours after injection and reached 20% of the initial value at 24 h. In contrast, no rapid decrease was observed after treatment and more than 50% of tracer remained at 24 h after injection. Semiquantitative analysis of tracer clearance may provide additional information in the diagnosis of CSF leakage, especially with no obvious qualitative findings.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University of Yamanashi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Horikoshi
authors.forename: H
authors.initials: H
authors.lastname: Ikegawa
authors.forename: M
authors.initials: M
authors.lastname: Uchida
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: A
authors.initials: A
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Umeda
mesh_terms: D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009192:Myelography / Q000379:methods; D015282:Octreotide / Q000031:analogs & derivatives* / Q000134:cerebrospinal fluid; D004369:Pentetic Acid / Q000031:analogs & derivatives* / Q000134:cerebrospinal fluid; D011865:Radioisotope Dilution Technique; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000134:cerebrospinal fluid; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013353:Subdural Effusion / Q000134:cerebrospinal fluid* / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: C497824:111In-octreotide, DTPA(0)-; D019275:Radiopharmaceuticals; D004369:Pentetic Acid; D015282:Octreotide