MRI myelography, a feasible alternative to CT for detecting CSF leaks: Study

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-09-01T19:41:13+05:30 | Updated On 1 Sept 2021 7:41 PM IST

USA: MRI myelography is a less invasive way for detection of cerebrospinal fluid (CSF) leaks in spontaneous intracranial hypotension patients compared to the CT version of the same exam, finds a recent study. Also, MRI myelography performed comparably to the CT version. The study is published as a research letter in JAMA Neurology.

According to a team of researchers led by Angelique Sao-Mai Sy Tay, Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, and colleagues, the results could help clinicians expand their toolkit for patients suffering from this condition.

The authors wrote that "Eliminating radiation exposure, obviating the need for lumbar puncture and intrathecal contrast injection, and decreasing resource utilization and cost are among the most important advantages of MRM [MRI myelography] over CTM [CT myelography]."

Spontaneous intracranial hypotension (SIH) is an important cause of headaches. For initial evaluation of patients with suspected SIH, post-myelography computed tomography (CT myelography or CTM) has long been considered the gold standard for the detection of cerebrospinal fluid (CSF) leaks, but spine magnetic resonance imaging including heavily T2-weighted magnetic resonance myelography (MRM) may be a noninvasive alternative.

The researchers aimed to compare the diagnostic accuracy of MRM with CTM for the identification of spinal CSF leaks.

The study included 576 patients who underwent MR myelography and CT myelography exams. Of these, 276 (47.9%) were diagnosed with CSF leaks on both CT and MR myelography.

The results indicate MRI myelography could be a feasible alternative to CT.

The researchers found the following:

MR myelography and CT myelography findings conflicted in less than 2% of patients with spontaneous intracranial hypotension.
Positive agreement between the two exams was 99.6%, negative agreement was 97.7%, and overall agreement 98.6%.

"MRM may be a suitable alternative to CTM for the initial evaluation of patients with spontaneous intracranial hypotension," the authors concluded.

Reference:

The study titled, "Computed Tomography vs Heavily T2-Weighted Magnetic Resonance Myelography for the Initial Evaluation of Patients With Spontaneous Intracranial Hypotension," is published in JAMA Neurology.

DOI:https://jamanetwork.com/journals/jamaneurology/article-abstract/2783666

JAMA NeurologyMRI myelographyspontaneous intracranial hypotensioncomputed tomographyMagnetic resonance imaging

Source : JAMA Neurology

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751