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Magnetic resonance imaging predicted the therapeutic response of patients with spinal cerebrospinal fluid leakage undergoing targeted epidural blood patch
- Source :
- Br J Radiol
- Publication Year :
- 2021
-
Abstract
- Objective: Most patients with spinal cerebrospinal fluid (CSF) leakage require an epidural blood patch (EBP); however, the response to treatment is varied. This study aimed to compare the MRI findings at follow-up between EBP effective and non-effective groups and to identify imaging findings that predict EBP treatment failure. Methods: We retrospectively reviewed 48 patients who received EBP treatment for spinal CSF leakage. These patients were stratified into two groups: EBP effective (n = 27) and EBP non-effective (n = 21) using the results of the 3 month MRI as the end point. Results: Compared to the EBP non-effective group, the patients in the EBP effective group had a lower spinal CSF leakage number (2.67 vs 12.48; p = 0.001), lower spinal epidural fluid accumulation levels (3.00 vs 7.48; p = 0.004), brain descend (11.11% vs 38.10%; p = 0.027), pituitary hyperemia (18.52% vs 57.14%; p = 0.007), and decreased likelihood of ≥three numbers of spinal CSF leakage (25.93% vs 90.48%; p = 0.001) in the post-EBP MRI. Clinical non-responsiveness (OR: 57.84; 95% CI: 3.47–972.54; p = 0.005) and ≥three numbers of spinal CSF leakage (OR: 15.13; 95% CI: 1.45–159.06; p = 0.023) were associated with EBP failure. Between these variables, ≥three numbers of spinal CSF leakage identified using the post-EBP MRI demonstrated greater sensitivity in predicting EBP failure compared to clinical non-responsiveness (90.48% vs 61.9%). Conclusion: The number of spinal CSF leakage identified using the post-EBP MRI with a cut-off value of three is an effective predictor of EBP failure. Advances in knowledge: Compared to clinical responsiveness, the post-EBP MRI provided a more objective approach to predict the effectiveness of EBP treatment in patients with spinal CSF leakage.
- Subjects :
- Adult
Male
Neuroimaging
Cerebrospinal fluid
Medicine
Humans
Radiology, Nuclear Medicine and imaging
Leakage (electronics)
Retrospective Studies
Epidural blood patch
Cerebrospinal Fluid Leakage
medicine.diagnostic_test
Cerebrospinal Fluid Leak
Full Paper
business.industry
Headache
Magnetic resonance imaging
General Medicine
Response to treatment
Magnetic Resonance Imaging
Treatment Outcome
Anesthesia
Female
business
Blood Patch, Epidural
Follow-Up Studies
Subjects
Details
- ISSN :
- 1748880X
- Volume :
- 95
- Issue :
- 1129
- Database :
- OpenAIRE
- Journal :
- The British journal of radiology
- Accession number :
- edsair.doi.dedup.....b47906d3066aec2631d38d66999dca73