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. 2013 Nov 12;81(20):1789-92.
doi: 10.1212/01.wnl.0000435555.13695.22. Epub 2013 Oct 9.

Sensitivity of MRI of the spine compared with CT myelography in orthostatic headache with CSF leak

Amaal Starling  1 , Fatima Hernandez, Joseph M Hoxworth, Terrence Trentman, Rashmi Halker, Bert B Vargas, Eric Hastriter, David Dodick
Affiliations

Sensitivity of MRI of the spine compared with CT myelography in orthostatic headache with CSF leak

Amaal Starling et al. Neurology. .

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.

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