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OtherSPINE

Dynamic CT Myelography: A Technique for Localizing High-Flow Spinal Cerebrospinal Fluid Leaks

Patrick H. Luetmer and Bahram Mokri
American Journal of Neuroradiology September 2003, 24 (8) 1711-1714;
Patrick H. Luetmer
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Bahram Mokri
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    Fig 1.

    A 47-year-old man with a 4-year history of severe orthostatic headaches and tinnitus had documented low CSF opening pressures. Head MR imaging examinations showed diffuse pachymeningeal enhancement. Selected images from routine CT myelogram at the T5 (A), T6 (B), T7 (C), and T9 (D) interspaces demonstrate diffuse extrathecal contrast material (black arrows). The study lacks the temporal resolution necessary to locate the site of leak.

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    Fig 2.

    Axial dynamic CT myelogram at the level of the T7–T8 interspace in the left lateral decubitus (A), right lateral decubitus (B), supine (C), and prone (D) positions demonstrates accumulation of extra-arachnoid contrast material along the ventral right aspect of the thecal sac, which increases in attenuation in the right lateral decubitus positioning (open arrows). The final prone images, which were obtained 30 minutes after injection of contrast, demonstrate dilution of contrast material in the previously unopacified epidural fluid collection and outlines the underlying T7 disk protrusion (black arrow)

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    Fig 3.

    Axial dynamic CT myelogram at the level of the C7–T1 interspace in the left lateral decubitus (A), right lateral decubitus (B), supine (C), and prone (D) positions demonstrates accumulation of extra-arachnoid contrast material along the left C8 root sleeve (open arrow). The final prone images, which were obtained 30 minutes after injection of contrast material, demonstrate dilution of contrast material in the previously unopacified epidural fluid collection (black arrow). Additional leaks were located at the level of the right T6 root sleeve and along the ventral aspect of the junction of the right T9 root sleeve and thecal sac (not pictured).

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American Journal of Neuroradiology: 24 (8)
American Journal of Neuroradiology
Vol. 24, Issue 8
1 Sep 2003
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Dynamic CT Myelography: A Technique for Localizing High-Flow Spinal Cerebrospinal Fluid Leaks
Patrick H. Luetmer, Bahram Mokri
American Journal of Neuroradiology Sep 2003, 24 (8) 1711-1714;

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Dynamic CT Myelography: A Technique for Localizing High-Flow Spinal Cerebrospinal Fluid Leaks
Patrick H. Luetmer, Bahram Mokri
American Journal of Neuroradiology Sep 2003, 24 (8) 1711-1714;
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