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Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension
PURPOSE: To assess early renal pelvis opacification on postmyelography computed tomography (CT) as a marker for cerebrospinal fluid (CSF) loss in patients with spontaneous intracranial hypotension (SIH). METHODS: The SIH patients referred to our hospital between January 2012 and May 2018 were retros...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187529/ https://www.ncbi.nlm.nih.gov/pubmed/34170368 http://dx.doi.org/10.1007/s00062-021-01042-0 |
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author | Piechowiak, Eike I. Bär, Laura Häni, Levin Branca, Mattia Kaesmacher, Johannes Mordasini, Pasquale Raabe, Andreas Ulrich, Christian T. Gralla, Jan Beck, Jürgen Dobrocky, Tomas |
author_facet | Piechowiak, Eike I. Bär, Laura Häni, Levin Branca, Mattia Kaesmacher, Johannes Mordasini, Pasquale Raabe, Andreas Ulrich, Christian T. Gralla, Jan Beck, Jürgen Dobrocky, Tomas |
author_sort | Piechowiak, Eike I. |
collection | PubMed |
description | PURPOSE: To assess early renal pelvis opacification on postmyelography computed tomography (CT) as a marker for cerebrospinal fluid (CSF) loss in patients with spontaneous intracranial hypotension (SIH). METHODS: The SIH patients referred to our hospital between January 2012 and May 2018 were retrospectively reviewed and divided into 2 groups based on the presence of spinal longitudinal extrathecal CSF collection (SLEC): (1) SLEC(+) with, and (2) SLEC(−) without proof of SLEC on multimodal imaging. Non-SIH patients (n = 20) undergoing CT myelography served as controls. The renal pelvis density on postmyelography CT was measured in all patients. Mean difference in renal pelvis density between the groups was calculated. RESULTS: In total, 111 SIH patients (mean age 48 ± 13 years; 60% female) were included, 71 (64%) SLEC(+) and 40 (36%) SLEC(−). The adjusted renal pelvis density in the SLEC(+), SLEC(−), and the non-SIH group was 108 Hounsfield unit (HU), 83 HU, and 32 HU, respectively, resulting in a significant difference between SLEC(+) vs. control group 1 (75 HU, p < 0.001), SLEC(−) vs. control group 1 (50 HU, p < 0.001), and a tendency for higher density in SLEC(+) than SLEC(−) (25 HU, p = 0.16). CONCLUSION: Increased renal pelvis opacification on postmyelography CT was observed in SIH patients, even in the absence of a CSF leak or a CSF venous fistula, when compared to non-SIH patients. Although the provenance of early renal opacification in SLEC (−) SIH patients remains unclear, our results suggest that it may be a surrogate for increased spinal CSF resorption via spinal arachnoid granulations and along spinal nerve sheaths occult to direct imaging. |
format | Online Article Text |
id | pubmed-9187529 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-91875292022-06-12 Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension Piechowiak, Eike I. Bär, Laura Häni, Levin Branca, Mattia Kaesmacher, Johannes Mordasini, Pasquale Raabe, Andreas Ulrich, Christian T. Gralla, Jan Beck, Jürgen Dobrocky, Tomas Clin Neuroradiol Original Article PURPOSE: To assess early renal pelvis opacification on postmyelography computed tomography (CT) as a marker for cerebrospinal fluid (CSF) loss in patients with spontaneous intracranial hypotension (SIH). METHODS: The SIH patients referred to our hospital between January 2012 and May 2018 were retrospectively reviewed and divided into 2 groups based on the presence of spinal longitudinal extrathecal CSF collection (SLEC): (1) SLEC(+) with, and (2) SLEC(−) without proof of SLEC on multimodal imaging. Non-SIH patients (n = 20) undergoing CT myelography served as controls. The renal pelvis density on postmyelography CT was measured in all patients. Mean difference in renal pelvis density between the groups was calculated. RESULTS: In total, 111 SIH patients (mean age 48 ± 13 years; 60% female) were included, 71 (64%) SLEC(+) and 40 (36%) SLEC(−). The adjusted renal pelvis density in the SLEC(+), SLEC(−), and the non-SIH group was 108 Hounsfield unit (HU), 83 HU, and 32 HU, respectively, resulting in a significant difference between SLEC(+) vs. control group 1 (75 HU, p < 0.001), SLEC(−) vs. control group 1 (50 HU, p < 0.001), and a tendency for higher density in SLEC(+) than SLEC(−) (25 HU, p = 0.16). CONCLUSION: Increased renal pelvis opacification on postmyelography CT was observed in SIH patients, even in the absence of a CSF leak or a CSF venous fistula, when compared to non-SIH patients. Although the provenance of early renal opacification in SLEC (−) SIH patients remains unclear, our results suggest that it may be a surrogate for increased spinal CSF resorption via spinal arachnoid granulations and along spinal nerve sheaths occult to direct imaging. Springer Berlin Heidelberg 2021-06-25 2022 /pmc/articles/PMC9187529/ /pubmed/34170368 http://dx.doi.org/10.1007/s00062-021-01042-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Piechowiak, Eike I. Bär, Laura Häni, Levin Branca, Mattia Kaesmacher, Johannes Mordasini, Pasquale Raabe, Andreas Ulrich, Christian T. Gralla, Jan Beck, Jürgen Dobrocky, Tomas Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension |
title | Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension |
title_full | Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension |
title_fullStr | Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension |
title_full_unstemmed | Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension |
title_short | Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension |
title_sort | renal pelvis opacification on postmyelography computed tomography as an indicator for cerebrospinal fluid loss in spontaneous intracranial hypotension |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187529/ https://www.ncbi.nlm.nih.gov/pubmed/34170368 http://dx.doi.org/10.1007/s00062-021-01042-0 |
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