Madhavan Ajay A, Kranz Peter G, Brinjikji Waleed, Mark Ian T, Amrhein Timothy J
From the Division of Neuroradiology (A.A.M., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota
Division of Neuroradiology (P.G.K., T.J.A.), Department of Radiology, Duke Health, Durham, North Carolina.
AJNR Am J Neuroradiol. 2025 Apr 2;46(4):846. doi: 10.3174/ajnr.A8736.
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.
光子计数CT脊髓造影是一种相对较新描述的用于检测自发性颅内低压患者脊髓脑脊液漏的技术。在本视频中，我们概述了CT脊髓造影中用于检测脑脊液漏的基本操作技术，以及使用光子计数CT时可用的特定优势和重建选项。此外，我们展示了在光子计数CT脊髓造影上检测到的常见脊髓脑脊液漏的典型表现示例，主要包括硬脑膜撕裂和脑脊液静脉瘘。本视频借鉴了多机构视角获得的技术见解，而不同中心的具体技术仍有所不同。多个中心对光子计数CT脊髓造影技术的未来改进将有助于最大程度地利用这项新兴技术。
