Gadolinium-enhanced MR cisternography to evaluate dural leaks in intracranial hypotension syndrome.
OBJECTIVE
We evaluated the use of MR cisternography after intrathecal administration of gadopentetate dimeglumine to detect the presence and localization of CSF leaks in 19 patients diagnosed with spontaneous intracranial hypotension syndrome according to the criteria of International Headache Society.


METHODS
Lumbar puncture with an injection of 0.5 mL of gadopentetate dimeglumine into the subarachnoid space in the lumbar area was performed. MR images of the cervical, thoracic, and lumbar regions in axial, coronal, and sagittal planes with fat-saturated T1-weighted images were acquired.


RESULTS
We observed objective CSF leakage in 17 (89%) of 19 patients. In 14 of these 17 patients, the site of dural tear was demonstrated accurately. In 3 of these 17 patients, the contrast leakage was diffuse, and site of the leak could not be located accurately. No leakage was observed in 2 patients. No complications were detected in any of the patients during the first 24 hours after the procedure or during the 6- to 12-month follow-up.


CONCLUSIONS
The current results demonstrate the relative safety, accuracy, and feasibility of intrathecal gadolinium-enhanced MR cisternography to evaluate dural leaks.
Albayram
S
S
Division of Neuroradiology, Department of Radiology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey. salbayram@hotmail.com
Kilic
F
F
Ozer
H
H
Baghaki
S
S
Kocer
N
N
Islak
C
C
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005402:Fistula / Q000150:complications / Q000175:diagnosis*; D005682:Gadolinium / Q000008:administration & dosage*; D006801:Humans; D007278:Injections, Spinal; D019585:Intracranial Hypotension / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D005682:Gadolinium