Spinal Cerebrospinal Fluid Leak Localization with Digital Subtraction Myelography: Tips, Tricks, and Pitfalls

Radiol Clin North Am. 2024 Mar;62(2):321-332. doi: 10.1016/j.rcl.2023.10.004. Epub 2023 Nov 11.ABSTRACTCerebrospinal fluid (CSF) leak can cause spontaneous intracranial hypotension (SIH) which can lead to neurologic symptoms, such as orthostatic headache. Over time, imaging techniques for detecting and localizing CSF leaks have improved. These techniques include computed tomography (CT) myelography, dynamic CT myelography, cone-beam CT, MRI, MR myelography, and digital subtraction myelography (DSM). DSM provides the highest sensitivity for identifying leak sites and has comparable radiation exposure to CT myelography. The introduction of the lateral decubitus DSM has proven invaluable in localizing leaks when other imaging tests have been inconclusive.PMID:38272624 | DOI:10.1016/j.rcl.2023.10.004
Source: Radiologic Clinics of North America - Category: Radiology Authors: Source Type: research