ArticleJournal of neurointerventional surgery2024
Direct comparison of digital subtraction myelography versus CT myelography in lateral decubitus position: evaluation of diagnostic yield for cerebrospinal fluid-venous fistulas.
Article in Journal of neurointerventional surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- Spontaneous intracranial hypotension: A stepwise diagnostic and therapeutic workflow from a tertiary referral center.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Review
- Efficacy of transvenous embolization of CSF-venous fistula in spontaneous intracranial hypotension: Case-series.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Trigeminal Neuralgia After a Cerebrospinal Fluid Leak: A Case Report.A&A practice · 2026Article
- Low interstitial fluid in patients with spontaneous intracranial hypotension.Fluids and barriers of the CNS · 2026Article
- Spontaneous Intracranial Hypotension and CSF-Venous Fistulae: from Diagnostic Imaging to Interventional Management.Clinical neuroradiology · 2026Review
- Bilateral subdural hematomas in spontaneous intracranial hypotension: A systematic review with case illustration.Surgical neurology international · 2026Review
- Volumetric response after closure of a spinal CSF leak in patients with spontaneous intracranial hypotension: a multicompartmental longitudinal study.Journal of neurointerventional surgery · 2025Article
- Additional Diagnostic Value of Conebeam CT Myelography Performed after Digital Subtraction Myelography for Detecting CSF-Venous Fistulas.AJNR. American journal of neuroradiology · 2025Article
- Assessing the Diagnostic Value of Brain White Matter Hyperintensities and Clinical Symptoms in Predicting the Detection of CSF-Venous Fistula in Patients with Suspected Spontaneous Intracranial Hypotension.AJNR. American journal of neuroradiology · 2025Article
- Identifying Cerebral Spinal Fluid Leaks by Catheter Targeted Dynamic Myelograms with Directed Intrathecal Enhancement Tomography (DIET) Technique.Stroke (Hoboken, N.J.) · 2025Article
- Density and Time Characteristics of CSF-Venous Fistulas on CT Myelography in Patients with Spontaneous Intracranial Hypotension.AJNR. American journal of neuroradiology · 2025Article
- Reply: Dementia in spontaneous intracranial hypotension: look at the spine.Neuroradiology · 2025Article
- Myelographic Techniques for the Localization of CSF-Venous Fistulas: Updates in 2024.AJNR. American journal of neuroradiology · 2024Review
- Diagnostic Yield of Decubitus CT Myelography for Detection of CSF-Venous Fistulas.AJNR. American journal of neuroradiology · 2024Article
- Spinal dementia: Don't miss it, it's treatable.Neuroradiology · 2024Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCerebrospinal fluid (CSF)-venous fistulas (CVFs) are increasingly identified as a cause of spontaneous intracranial hypotension (SIH). Lateral decubitus digital subtraction myelography (LD-DSM) and CT myelography (LD-CTM) are mainly used for detection, but the most sensitive method is yet unknown.
objectiveTo compare LD-DSM with LD-CTM for diagnostic yield of CVFs.
methodsPatients with SIH diagnosed with a CVF between January 2021 and December 2022 in which the area of CVF(s) was covered by both diagnostic modalities were included. LD-CTM immediately followed LD-DSM without repositioning the spinal needle, and the second half of the contrast agent was injected at the CT scanner. Patients were awake or mildly sedated. Retrospectively, two neuroradiologists evaluated data independently and blinded for the presence of CVF.
resultsTwenty patients underwent a total of 27 combined LD-DSM/LD-CTM examinations (4/20 with follow-up and 3/20 with bilateral examinations). Both raters identified significantly more CVFs with LD-CTM than with LD-DSM (rater 1: 39 vs 9, P<0.001; rater 2: 42 vs 12, P<0.001). Inter-rater agreement was substantial for LD-DSM (κ=0.732) and LD-CTM (κ=0.655). The results remained significant after considering the senior rating for cases of disagreement (39 vs 10; P<0.001), and no CVF detected on LD-DSM was missed on LD-CTM.
conclusionIn this study, LD-CTM has a higher diagnostic yield for the detection of CVFs than LD-DSM and should supplement LD-DSM, but further studies are needed. LD-CTM can be easily acquired in awake or mildly sedated patients with the second half of contrast injected just before CT scanning, or it may be considered as a stand-alone investigation.
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