RT Journal Article
SR Electronic
T1 Utility of Dual-Energy CT to Improve Diagnosis of CSF Leaks on CT Myelography following Lateral Decubitus Digital Subtraction Myelography with Negative Findings
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A7628
A1 S.J. Huls
A1 D.P. Shlapak
A1 D.K. Kim
A1 S. Leng
A1 C.M. Carr
YR 2022
UL http://www.ajnr.org/content/early/2022/09/08/ajnr.A7628.abstract
AB SUMMARY: CSF leaks, including CSF-venous fistulas, which cause spontaneous intracranial hypotension, remain difficult to diagnose, even on digital subtraction myelography and CT myelography. Dual-energy CT technology has been used to improve diagnostic utility within multiple organ systems. The capability of dual-energy CT to create virtual monoenergetic images can be leveraged to increase conspicuity of contrast in CSF-venous fistulas and direct epidural CSF leakage to improve the diagnostic utility of CT myelography. Six cases (in 5 patients) are shown in which virtual monoenergetic images demonstrate a leak location that was either occult or poorly visible on high- or low-kilovolt series. This clinical report describes the novel application of dual-energy CT for the detection of subtle CSF leaks including CSF-venous fistulas.CTDIvolvolume CT dose indexCTMCT myelographyCVFCSF-venous fistulaDECTdual-energy CTDSMdigital subtraction myelographyLDDSMlateral decubitus digital subtraction myelographySIHspontaneous intracranial hypotensionVMIvirtual monoenergetic images