Evidence map›Paper›PMID 34292360›Full record

ArticleClinical neuroradiology2022

Diagnostic Yield of Intrathecal Gadolinium MR Myelography for CSF Leak Localization.

Ajay A Madhavan, Carrie M Carr, John C Benson, Waleed Brinjikji, Felix E Diehn, Dong Kun Kim, Vance T Lehman, Greta B Liebo, Pearse P Morris, Darya P Shlapak and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in Clinical neuroradiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Review
  10. Intravenous Contrast-Enhanced MR Myelography in CSF Leakage for the Detection of Spinal CSF Lamellae.Journal of neuroimaging : official journal of the American Society of Neuroimaging
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Ajay A MadhavanDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA. madhavan.ajay@mayo.edu.
Carrie M CarrDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
John C BensonDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Waleed BrinjikjiDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Felix E DiehnDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Dong Kun KimDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Vance T LehmanDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Greta B LieboDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Pearse P MorrisDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Darya P ShlapakDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Jared T VerdoornDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Jonathan M MorrisDepartment of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Mayo Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntrathecal gadolinium magnetic resonance (MR) myelography can be used to localize various types of spinal cerebrospinal fluid (CSF) leaks; however, its diagnostic yield is not well known. We sought to determine the diagnostic yield of MR myelography in patients with spontaneous intracranial hypotension.

methodsA retrospective review was performed on all patients who had undergone intrathecal gadolinium MR myelography at our institution from 2002 to 2020 for suspected spinal CSF leak. The MR myelography images were reviewed for the presence or absence of a spinal CSF leak site. Images were also evaluated for the presence an extradural fluid collection.

resultsA total of 97 patients were included in the final cohort. The average age was 52.6 years; 67.0% were female, 4 patients underwent 2 examinations each, yielding a total of 101 MR myelograms. The source of a spinal CSF leak was localized in 14 patients. The diagnostic yield for CSF leak localization on intrathecal gadolinium MR myelography was 14/101 (13.9%) per GdM examination and 14/97 (14.4%) per patient. Among the subset of patients without extradural fluid collections, the yield was 15.7% per examination. All detected leaks were either CSF-venous fistulas or distal nerve root sleeve tears.

conclusionIntrathecal gadolinium MR myelography is capable of localizing CSF-venous fistulas and distal nerve root sleeve tears; however, our data show that it has a limited diagnostic yield. We suggest that other modalities may be a better first step before attempting intrathecal gadolinium MR myelography.

Indexed as

FistulaIntracranial HypotensionCerebrospinal Fluid LeakFemaleGadoliniumHumansMagnetic Resonance ImagingMagnetic Resonance SpectroscopyMaleMiddle AgedMyelographyGadoliniumCSF leakCSF-venous fistulaDigital subtraction myelographyIntrathecal gadolinium MR myelographySIH

Identifiers

PMID34292360
OpenAlexW3186160201

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.