应用 111In-DTPA 脑池造影术对脑脊液漏入胸腔的明确诊断。

Definitive diagnosis of cerebrospinal fluid leak into the pleural space using 111In-DTPA cisternography.

机构信息

From the Divisions of *Nuclear Medicine, and †Neuroradiology, Department of Radiology, and ‡Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, NC.

出版信息

Clin Nucl Med. 2015 Mar;40(3):220-3. doi: 10.1097/RLU.0000000000000541.

DOI:10.1097/RLU.0000000000000541

PMID:25243944

Abstract

A 58-year-old woman with a calcified disk extrusion causing severe spinal stenosis underwent T8 to T9 diskectomy and spinal fusion. A postoperative pseudomeningocele was treated with lumbar drain and fibrin glue. Performed for persistent right pleural effusion, CT myelogram failed to show communication between the cerebrospinal fluid (CSF) and pleural space--even on 2-hour delayed images. Subsequent 111In-DTPA cisternogram clearly demonstrated CSF leakage into the right pleural space at 2 hours, and surgical repair yielded good results. Radionuclide cisternography is a highly useful method to detect CSF leak, especially when it is occult on CT yet suspected clinically.

摘要

一位 58 岁女性因钙化的椎间盘突出导致严重的脊柱狭窄，接受了 T8 到 T9 椎间盘切除术和脊柱融合术。术后发生假性脑脊膜膨出，采用腰大池引流和纤维蛋白胶治疗。因持续存在右侧胸腔积液进行检查，CT 脊髓造影未能显示脑脊液（CSF）与胸腔之间的连通——甚至在 2 小时延迟图像上也没有。随后的 111In-DTPA 脑池造影术在 2 小时时清晰显示 CSF 漏入右侧胸腔，手术修复效果良好。放射性核素脑池造影术是一种非常有用的方法来检测 CSF 漏，特别是在 CT 上隐匿但临床上怀疑时。