ArticleAJNR. American journal of neuroradiology2020
Spine MRI in Spontaneous Intracranial Hypotension for CSF Leak Detection: Nonsuperiority of Intrathecal Gadolinium to Heavily T2-Weighted Fat-Saturated Sequences.
Article in AJNR. American journal of neuroradiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Temporal and regional trends in the diagnosis and treatment of spontaneous intracranial hypotension: a systematic review.The journal of headache and pain · 2026Pooled it
- A technique to localize posteriorly located spinal dural leaks associated with spontaneous intracranial hypotension: Dorsal-decubitus dynamic CT myelography.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Targeted repair of a refractory ventral cerebrospinal fluid leak identified by dynamic computed tomography myelography: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Duropathies as Unifying Concept-Part Two: A Narrative Overview of Clinical and Neuroradiological Features.Neurology international · 2026Review
- Standardized spinal MRI protocol: diagnosing spontaneous intracranial hypotension and correlating with brain MRI.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Percutaneous CT-guided Onyx embolization of CSF-venous fistula: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Cerebrospinal fluid dynamics and subarachnoid space occlusion following traumatic spinal cord injury in the pig: an investigation using magnetic resonance imaging.Fluids and barriers of the CNS · 2025Article
- Spinal CSF Leaks: The Neuroradiologist Transforming Care.AJNR. American journal of neuroradiology · 2024Article
- Deep learning-based reconstruction for 3-dimensional heavily T2-weighted fat-saturated magnetic resonance (MR) myelography in epidural fluid detection: image quality and diagnostic performance.Quantitative imaging in medicine and surgery · 2024Article
- Comparing 2-dimensional versus 3-dimensional MR myelography for cerebrospinal fluid leak detection.European journal of radiology open · 2024Article
- Spontaneous Intracranial Hypotension: Case Report and Update on Diagnosis and Treatment.Diagnostics (Basel, Switzerland) · 2024Article
- Sacral Dural Tears as a Cause of Spontaneous Intracranial Hypotension.Clinical neuroradiology · 2023Article
- Spontaneous Intracranial Hypotension in Pregnancy.Current pain and headache reports · 2023Review
- Modified Dynamic CT Myelography for Type 1 and 2 CSF Leaks: A Procedural Approach.AJNR. American journal of neuroradiology · 2023Article
- Epidural Blood Patching in Spontaneous Intracranial Hypotension-Do we Really Seal the Leak?Clinical neuroradiology · 2023Article
- Diagnostic Yield of Intrathecal Gadolinium MR Myelography for CSF Leak Localization.Clinical neuroradiology · 2022Article
- Magnetic resonance imaging predicted the therapeutic response of patients with spinal cerebrospinal fluid leakage undergoing targeted epidural blood patch.The British journal of radiology · 2022Article
- Spontaneous intracranial hypotension: diagnostic and therapeutic workup.Neuroradiology · 2021Review
- Multiple Spinal CSF Leaks in Spontaneous Intracranial Hypotension: Do They Exist?Neurology. Clinical practice · 2021Article
- Role of Conventional Dynamic Myelography for Detection of High-Flow Cerebrospinal Fluid Leaks : Optimizing the Technique.Clinical neuroradiology · 2021Article
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeSpine MR imaging plays a pivotal role in the diagnostic work-up of spontaneous intracranial hypotension. The aim of this study was to compare the diagnostic accuracy of unenhanced spine MR imaging and intrathecal gadolinium-enhanced spine MR imaging for identification and localization of CSF leaks in patients with spontaneous intracranial hypotension. MATERIALS AND
methodsA retrospective study of patients with spontaneous intracranial hypotension examined from February 2013 to October 2017 was conducted. Their spine MR imaging was reviewed by 3 blinded readers for the presence of epidural CSF using 3 different sequences (T2WI, 3D T2WI fat-saturated, T1WI gadolinium). In patients with leaks, the presumed level of the leak was reported.
resultsIn total, 103 patients with spontaneous intracranial hypotension (63/103 [61%] women; mean age, 50 years) were evaluated. Seventy had a confirmed CSF leak (57/70 [81%] proved intraoperatively), and 33 showed no epidural CSF on multimodal imaging. Intrathecal gadolinium-enhanced spine MR imaging was nonsuperior to unenhanced spine MR imaging for the detection of epidural CSF (
conclusionsIntrathecal gadolinium-enhanced spine MR imaging does not improve the diagnostic accuracy for the detection of epidural CSF. Thus, it lacks a rationale to be included in the routine spontaneous intracranial hypotension work-up. Heavily T2-weighted images with fat saturation provide high accuracy for the detection of an epidural CSF collection. Low accuracy for leak localization is due to an extensive CSF collection spanning several vertebrae (false localizing sign), lack of temporal resolution, and a multiplicity of suspicious lesions, albeit only a single leakage site is present. Thus, dynamic examination is mandatory before targeted treatment is initiated.
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