title: Definitive diagnosis of cerebrospinal fluid leak into the pleural space using 111In-DTPA cisternography.
abstract: A 58-year-old woman with a calcified disk extrusion causing severe spinal stenosis underwent T8 to T9 diskectomy and spinal fusion. A postoperative pseudomeningocele was treated with lumbar drain and fibrin glue. Performed for persistent right pleural effusion, CT myelogram failed to show communication between the cerebrospinal fluid (CSF) and pleural space--even on 2-hour delayed images. Subsequent 111In-DTPA cisternogram clearly demonstrated CSF leakage into the right pleural space at 2 hours, and surgical repair yielded good results. Radionuclide cisternography is a highly useful method to detect CSF leak, especially when it is occult on CT yet suspected clinically.
authors.affiliation: From the Divisions of *Nuclear Medicine, and †Neuroradiology, Department of Radiology, and ‡Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Howard
authors.forename: Linda
authors.initials: L
authors.lastname: Gray
authors.forename: Robert E
authors.initials: RE
authors.lastname: Isaacs
authors.forename: Salvador
authors.initials: S
authors.lastname: Borges-Neto
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008875:Middle Aged; D004369:Pentetic Acid; D035422:Pleural Cavity / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D004369:Pentetic Acid