Floating Dural Sac Sign is a Sensitive Magnetic Resonance Imaging Finding of Spinal Cerebrospinal Fluid Leakage

• HOSOYA Takaaki

  Department of Diagnostic Radiology, Yamagata University Faculty of Medicine

• HATAZAWA Jun

  Department of Nuclear Medicine, Osaka University Graduate School of Medicine

• SATO Shinya

  Department of Neurosurgery, Yamagata University Faculty of Medicine

• KANOTO Masafumi

  Department of Diagnostic Radiology, Yamagata University Faculty of Medicine

• FUKAO Akira

  Department of Public Health, Yamagata University Graduate School of Medicine

• KAYAMA Takamasa

  Department of Neurosurgery, Yamagata University Faculty of Medicine

抄録

We would like to propose floating dural sac sign, which is observed as a hyperintense band or rim around the spinal dural sac on axial T₂-weighted images, as a sensitive sign to identify cerebrospinal fluid (CSF) leakage. One hundred patients with orthostatic headache were prospectively registered in 11 hospitals. These patients were examined by brain magnetic resonance (MR) imaging (n = 89), radioisotope cisternography (n = 89), MR myelography (n = 86), axial T₂-weighted imaging of the spine (n = 70), and computed tomography myelography (n = 2). In this study, we separately evaluated the imaging findings of intracranial hypotension and spinal CSF leakage. Among 100 patients, 16 patients were diagnosed as having spinal CSF leaks. Of 70 patients examined with axial T₂-weighted imaging, 14 patients were diagnosed with spinal CSF leaks, and floating dural sac sign was observed in 17 patients, 13 patients with spinal CSF leaks and 4 without CSF leaks (sensitivity 92.9%, specificity 92.9%). Of 86 patients examined by MR myelography, extradural fluid was observed in only 3 patients (sensitivity 21.4%, specificity 100%). The floating dural sac sign was a sensitive sign that can be used to identify CSF leakage. Spinal axial T₂-weighted imaging might be a good screening method for spinal CSF leakage that can help to avoid the need for lumbar puncture.<br>

収録刊行物

• Neurologia medico-chirurgica

  Neurologia medico-chirurgica 53 (4), 207-212, 2013

  一般社団法人 日本脳神経外科学会

キーワード

• cerebrospinal fluid leakage
• spontaneous intracranial hypotension
• spinal magnetic resonance imaging
• T₂-weighted magnetic resonance imaging
• lumbar puncture

詳細情報

• CRID: 1390001205058531072
• NII論文ID: 10031151331
• NII書誌ID: AN00358613
• DOI: 10.2176/nmc.53.207
• COI: 1:STN:280:DC%2BC3srot1antQ%3D%3D
• ISSN: 13498029
• ISSN: 04708105
• PubMed: 23615408
• Web Site: https://www.jstage.jst.go.jp/article/nmc/53/4/53_2012-0144/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2014127734
• 本文言語コード: en
• データソース種別:
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  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可