Photon-Counting CT Myelography for the Detection of Spinal CSF Leaks.
Ajay A Madhavan, Peter G Kranz, Waleed Brinjikji, Ian T Mark, Timothy J Amrhein
Author Information
Ajay A Madhavan: From the Division of Neuroradiology (A.A.M., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota madhavan.ajay@mayo.edu. ORCID
Peter G Kranz: Division of Neuroradiology (P.G.K., T.J.A.), Department of Radiology, Duke Health, Durham, North Carolina. ORCID
Waleed Brinjikji: From the Division of Neuroradiology (A.A.M., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota. ORCID
Ian T Mark: From the Division of Neuroradiology (A.A.M., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota. ORCID
Timothy J Amrhein: Division of Neuroradiology (P.G.K., T.J.A.), Department of Radiology, Duke Health, Durham, North Carolina. ORCID
Photon-counting CT myelography is a relatively recently described technique for the detection of spinal CSF leaks in patients with spontaneous intracranial hypotension. In this Video, we outline the fundamental procedural techniques used in CT myelography for CSF leak detection, as well as specific advantages and reconstruction options available when using photon-counting CT. Additionally, we show examples demonstrating the typical appearance of common spinal CSF leaks detected on photon-counting CT myelography, which mainly include dural tears and CSF-venous fistulas. This Video draws on technical insights gleaned from a multi-institutional perspective, while specific techniques continue to vary at different centers. Future refinement of photon-counting CT myelographic techniques at multiple centers will be helpful to maximally leverage this nascent technology.
