A 28-year-old woman with spinal CSF leak syndrome.

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Presentation transcript:

A 28-year-old woman with spinal CSF leak syndrome. A 28-year-old woman with spinal CSF leak syndrome. A, Anterior projection of RIC shows diffusion of the radioisotope into the extra-arachnoidal space in the region of the bilateral upper thoracic spine (arrowheads). B, On MR myelography, triangular-shaped CSF space expansion at multiple nerve root sleeves with reticular and streaky hyperintensities extending around the nerve root sleeves was identified in the corresponding upper thoracic spine (arrowheads). C, Normal MRM findings in a 50-year-old woman with low-back pain for comparison. Note incidental perineurial cysts in cervicothoracic junction level (arrows). They appear as round discrete hyperintensities at the nerve root sleeves in contrast to CSF leak noted on B. D, A presumed false-positive finding on MRM of a CSF leak in a 49-year-old woman with chronic back pain. The patient did not have symptoms of CSF leak syndrome. Both readers 1 and 2 reported grade 1 CSF leak at the thoracic level in this patient. There is hyperintensity at the midthoracic level (arrow). However, the shape is round, and there is no accompanying expansion at the nerve root sleeve. This may represent a perineurial cyst, but it is uncertain. H.-M. Yoo et al. AJNR Am J Neuroradiol 2008;29:649-654 ©2008 by American Society of Neuroradiology