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Abstract
Objective: To investigate the sensitivity of MRI of the spine compared with CT myelography (CTM) in detecting CSF leaks.
Methods: Between July 1998 and October 2010, 12 patients with orthostatic headache and a CTM-confirmed spinal CSF leak underwent an MRI of the spine with and without contrast. Using CTM as the gold standard, we retrospectively investigated the sensitivity of spinal MRI in detecting a CSF leak.
Results: Eleven of 12 patients with a CSF leak documented by CTM also had extradural fluid collections on spinal MRI (sensitivity 91.7%). Six patients with extradural fluid collections on spinal MRI also had spinal dural enhancement.
Conclusion: When compared with the gold standard of CTM, MRI of the spine appears to be a sensitive and less invasive imaging modality for detecting a spinal CSF leak, suggesting that MRI of the spine should be the imaging modality of first choice for the detection of spinal CSF leaks.
GLOSSARY
- CTM=
- CT myelography;
- EBP=
- epidural blood patch;
- MR=
- magnetic resonance;
- SIH=
- spontaneous intracranial hypotension
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received April 1, 2013.
- Accepted in final form August 15, 2013.
- © 2013 American Academy of Neurology
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