ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Standardized spinal MRI protocol: diagnosing spontaneous intracranial hypotension and correlating with brain MRI.
Article in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Spontaneous intracranial hypotension with negative brain MRI findings: a systematic review of diagnostic strategies and clinical outcomes.Frontiers in neurologyPooled it
- Automated Aqueductal CSF Flow Analysis in Spontaneous Intracranial Hypotension: Hemodynamic Quantification and Exploratory Waveform Morphology Assessment Using Cine PC-MRI.Diagnostics (Basel, Switzerland) · 2026Article
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5 authors.
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Abstract
purposeTo evaluate a standardized cervical-thoracic-lumbar (CTL) contrast-enhanced (CE)-MRI protocol for spinal findings in spontaneous intracranial hypotension (SIH) and their correlation with brain MRI.
methodsThis retrospective study included SIH-suspected patients who underwent spine MRI from March 2019 to February 2023. Diagnosis was based on clinical criteria, using a 3T MRI with a standardized spine protocol. MRI diagnostic criteria included spinal (e.g., spinal longitudinal epidural fluid collection [SLEC], dural enhancement [DE]) and brain findings (four qualitative methods including venous sinus engorgement [VSE], pachymeningeal enhancement [PE], and brain sagging [BS] as confirmatory diagnostic criteria; and four quantitative methods). Patients were classified into Group 1 (brain MRI-positive showing VSE, PE or BS) and Group 2 (brain MRI-negative). Demographics and MRI findings were compared in both groups using t-tests or chi-square statistics.
resultsAmong 53 SIH patients, 42 with spine MRI-positive findings underwent brain MRI (mean age 43.95 ± 12.26 years, 66.7% female), with 27 in Group 1 and 15 in Group 2. Group 1 demonstrated significantly wider sagittal and axial extents of SLEC (full range: 85.2%, circumferential: 82.1%; p < 0.001, p = 0.011), and a higher prevalence of the C1-2 sign, while Group 2 exhibited these features less frequently (85.2% vs. 53.3%, p = 0.024). Brain MRI findings in Group 1 included VSE (92.6%), PE (66.7%), and BS (7.4%), with subdural fluid collection also higher (37.0%, p = 0.007). Other brain parameters showed no significant differences.
conclusionThe standardized CTL CE-MRI protocol enables comprehensive SIH diagnosis, when brain MRI findings are negative or equivocal.
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