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Video ArticleSPINE IMAGING AND SPINE IMAGE-GUIDED INTERVENTIONS

Conebeam CT Myelography for the Detection of Spinal CSF Leaks

Ajay A. Madhavan, Michelle L. Kodet, Waleed Brinjikji, Ian T. Mark and Wouter I. Schievink
American Journal of Neuroradiology May 2025, DOI: https://doi.org/10.3174/ajnr.A8820
Ajay A. Madhavan
aFrom the Division of Neuroradiology (A.A.M., M.L.K., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota
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  • ORCID record for Ajay A. Madhavan
Michelle L. Kodet
aFrom the Division of Neuroradiology (A.A.M., M.L.K., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Waleed Brinjikji
aFrom the Division of Neuroradiology (A.A.M., M.L.K., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Ian T. Mark
aFrom the Division of Neuroradiology (A.A.M., M.L.K., W.B., I.T.M.), Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Wouter I. Schievink
bDepartment of Neurosurgery (W.I.S.), Cedars-Sinai Medical Center, Los Angeles, California
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ABSTRACT

Spinal CSF leaks are the primary cause of spontaneous intracranial hypotension, with the most common types of leaks including CSF-venous fistulas and dural tears.1 These leaks necessitate advanced myelographic techniques for accurate localization. Digital subtraction myelography is one such technique used at some institutions.2 Although digital subtraction myelography has excellent temporal and spatial resolution, it does not provide high-resolution cross-sectional images. Here, we describe our technique for conebeam CT myelography performed immediately after digital subtraction myelography, which generates high-resolution cross-sectional images.3⇓⇓-6 We illustrate how this technique enhances detection and characterization of some spinal CSF leaks.

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  • © 2025 by American Journal of Neuroradiology
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Cite this article
Ajay A. Madhavan, Michelle L. Kodet, Waleed Brinjikji, Ian T. Mark, Wouter I. Schievink
Conebeam CT Myelography for the Detection of Spinal CSF Leaks
American Journal of Neuroradiology May 2025, DOI: 10.3174/ajnr.A8820

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Cone Beam CT Myelography
Ajay A. Madhavan, Michelle L. Kodet, Waleed Brinjikji, Ian T. Mark, Wouter I. Schievink
American Journal of Neuroradiology May 2025, DOI: 10.3174/ajnr.A8820
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