The usefulness of MDCT-myelography for patients with spontaneous intracranial hypotension.
OBJECTIVE
The detection and localization of cerebrospinal fluid (CSF) leakage in patients with spontaneous intracranial hypotension (SIH) is important. The aim of this study was to evaluate the usefulness of multidetector CT (MDCT)-myelography in patients with SIH.


METHODS
A radiologist retrospectively searched the electronic database to find the patients who had undergone MDCT-myelography for SIH between October 2010 and September 2014. In the MDCT-myelographic treatment, the patient's whole spine was scanned by 64 or 256 channel MDCT scanners after being injected with 20 ml of contrast agent via L3/4 interlaminar space under fluoroscopic guidance. Three radiologists in consensus determined the presence, pattern ("pseudodiverticular sign" or "gray-rim sign") and level of contrast leakage outside the dural sac.


RESULTS
Eighteen patients (M:F = 9:9; mean age, 36.2; age range 17-56) were finally included in this study. CSF leakage was detected in 17 of 18 patients. CSF leakage pattern was described as a "pseudodiverticular sign" in five and "gray-rim sign" in ten patients. Leakage level could be determined in ten patients based on MDCT-myelography.


CONCLUSIONS
MDCT-myelography was useful to detect CSF leakage and to guess the leakage level in patients with SIH.
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeongi-do 13620 South Korea.
Seung Woo
SW
Choi
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeongi-do 13620 South Korea.
Joong Mo
JM
Ahn
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeongi-do 13620 South Korea.
Joon Woo
JW
Lee
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Gyeongi-do 13620 South Korea.
Kyung Seok
KS
Park
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeongi-do 13620 South Korea.
Heung Sik
HS
Kang
CSF leakage; Multidetector CT-myelography; Spontaneous intracranial hypotension