Non-invasive biomarkers for spontaneous intracranial hypotension (SIH) through phase-contrast MRI

Abstract: Background and objective
Spontaneous intracranial hypotension (SIH) is an underdiagnosed disease. To depict the accurate diagnosis can be demanding; especially the detection of CSF–venous fistulas poses many challenges. Potential dynamic biomarkers have been identified through non-invasive phase-contrast MRI in a limited subset of SIH patients with evidence of spinal longitudinal extradural collection. This study aimed to explore these biomarkers related to spinal cord motion and CSF velocities in a broader SIH cohort.

Methods
A retrospective, monocentric pooled-data analysis was conducted of patients suspected to suffer from SIH who underwent phase-contrast MRI for spinal cord and CSF velocity measurements at segment C2/C3 referred to a tertiary center between February 2022 and June 2023. Velocity ranges (mm/s), total displacement (mm), and further derivatives were assessed and compared to data from the database of 70 healthy controls.

Results
In 117 patients, a leak was located (54% ventral leak, 20% lateral leak, 20% CSF–venous fistulas, 6% sacral leaks). SIH patients showed larger spinal cord and CSF velocities than healthy controls: e.g., velocity range 7.6 ± 3 mm/s vs. 5.6 ± 1.4 mm/s, 56 ± 21 mm/s vs. 42 ± 10 mm/s, p < 0.001, respectively. Patients with lateral leaks and CSF–venous fistulas exhibited an exceptionally heightened level of spinal cord motion (e.g., velocity range 8.4 ± 3.3 mm/s; 8.2 ± 3.1 mm/s vs. 5.6 ± 1.4 mm/s, p < 0.001, respectively).

Conclusion
Phase-contrast MRI might become a valuable tool for SIH diagnosis, especially in patients with CSF–venous fistulas without evidence of spinal extradural fluid collection

Objekt anzeigen

• Standort: Deutsche Nationalbibliothek Frankfurt am Main
• Umfang: Online-Ressource
• Sprache: Englisch
• Anmerkungen: Journal of neurology. - 271, 7 (2024) , 4336-4347, ISSN: 1432-1459

Beteiligte, Orts- und Zeitangaben

• Ereignis: Veröffentlichung
• (wo): Freiburg
• (wer): Universität
• (wann): 2024
• Urheber: Wolf, Katharina ; Volz, Florian ; Lützen, Niklas ; Mast, Hansjoerg ; Reisert, Marco ; El Rahal, Amir ; Fung, Christian ; Shah, Mukesch Johannes ; Beck, Jürgen ; Urbach, Horst

Weitere Informationen

• DOI: 10.1007/s00415-024-12365-6
• URN: urn:nbn:de:bsz:25-freidok-2474125
• Rechteinformation: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.