METHODS: All CTM performed over an 8-year period (n = 392) were retrospectively reviewed and included cases (n = 295) were divided into groups consisting of SIH patients with (n = 35) or without (n = 77) confirmed CSF leak on CTM and non-SIH controls (n = 183). Average and relative average (relative to systemic contrast density) RCS densities were compared with multivariate analysis adjusting for patient characteristics and CTM technical differences.
RESULTS: Average RCS densities were greater for confirmed versus non-confirmed SIH groups and greater for both SIH groups relative to non-SIH controls. Correlations between RCS density and time from injection to CTM were higher within SIH patient groups compared to controls. Measured RCS density had a higher negative predictive value for excluding CSF leak both within the SIH patient groups as well as the overall cohort (84% and 96%, respectively), with optimized thresholds yielding 80% sensitivity and 70% specificity for the presence of leak in the overall cohort.
CONCLUSIONS: Accounting for RCS density may provide reliable additional indirect diagnostic value about the suspicion of a CSF leak in patients undergoing CTM for evaluation of SIH symptoms.
方法:对8年期间所有CTM(n=392)进行回顾性分析,并将纳入的病例(n=295)分为SIH患者(n=35)或无(n=77)的CTM和非SIH对照(n=183)。将平均和相对平均(相对于全身对比密度)RCS密度与多变量分析进行比较,以调整患者特征和CTM技术差异。
结果:确认的SIH组与未确认的SIH组的平均RCS密度更大,而两个SIH组相对于非SIH对照组的平均RCS密度更大。与对照组相比,SIH患者组的RCS密度与从注射到CTM的时间之间的相关性更高。在SIH患者组和整体队列中,测量的RCS密度对于排除CSF泄漏具有较高的阴性预测值(84%和96%,分别),优化的阈值对整个队列中存在渗漏的敏感性为80%,特异性为70%.
结论:考虑RCS密度可能为评估SIH症状提供可靠的额外间接诊断价值。