Evidence map›Paper›PMID 39030336›Full record

ArticleNeuroradiology2024

Clinical utility of CT myelography renal collecting system density in the evaluation of spinal CSF leak or CSF-venous connection in patients with spontaneous intracranial hypotension.

Joshua Loewenstern, Pierce McMahon, Daiqi Wang, Andrew D Schweitzer, Gayle Salama, Sara Strauss

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Article in Neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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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

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Joshua LoewensternDepartment of Radiology, New York Presbyterian Hospital - Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA. jnl9006@nyp.org.ORCID http://orcid.org/0009-0003-1597-2603
Pierce McMahonDepartment of Radiology, New York Presbyterian Hospital - Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.
Daiqi WangDepartment of Radiology, New York Presbyterian Hospital - Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.
Andrew D SchweitzerDepartment of Radiology, New York Presbyterian Hospital - Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.
Gayle SalamaDepartment of Radiology, New York Presbyterian Hospital - Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.
Sara StraussDepartment of Radiology, New York Presbyterian Hospital - Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIdentifying spontaneous CSF leaks can be difficult on CT myelography (CTM) in patients with suspected spontaneous intracranial hypotension (SIH). The current study compared renal collecting system (RCS) density during CTM in patients with suspected SIH relative to non-SIH controls and evaluated the overall utility as an indirect sign of spontaneous CSF leak in patients with SIH.

methodsAll CTM performed over an 8-year period (n = 392) were retrospectively reviewed and included cases (n = 295) were divided into groups consisting of SIH patients with (n = 35) or without (n = 77) confirmed CSF leak on CTM and non-SIH controls (n = 183). Average and relative average (relative to systemic contrast density) RCS densities were compared with multivariate analysis adjusting for patient characteristics and CTM technical differences.

resultsAverage RCS densities were greater for confirmed versus non-confirmed SIH groups and greater for both SIH groups relative to non-SIH controls. Correlations between RCS density and time from injection to CTM were higher within SIH patient groups compared to controls. Measured RCS density had a higher negative predictive value for excluding CSF leak both within the SIH patient groups as well as the overall cohort (84% and 96%, respectively), with optimized thresholds yielding 80% sensitivity and 70% specificity for the presence of leak in the overall cohort.

conclusionAccounting for RCS density may provide reliable additional indirect diagnostic value about the suspicion of a CSF leak in patients undergoing CTM for evaluation of SIH symptoms.

Indexed as

Cerebrospinal Fluid LeakIntracranial HypotensionMyelographyTomography, X-Ray ComputedAdultAgedContrast MediaFemaleHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityContrast MediaCSF leakIntracranial hypotensionMyelographySpinal leak

Identifiers

PMID39030336

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