Clinical Neuroradiology最新文献

{"title":"Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy : Results from the ESCAPE-NA1 Trial.","authors":"Petra Cimflova,&nbsp;Nishita Singh,&nbsp;Johanna M Ospel,&nbsp;Martha Marko,&nbsp;Nima Kashani,&nbsp;Arnuv Mayank,&nbsp;Ricardo Hanel,&nbsp;Diogo C Haussen,&nbsp;Aditya Bharatha,&nbsp;David Volders,&nbsp;Manraj K S Heran,&nbsp;Alexandre Y Poppe,&nbsp;Brian van Adel,&nbsp;Bijoy K Menon,&nbsp;Manish Joshi,&nbsp;Andrew Demchuk,&nbsp;Ryan McTaggart,&nbsp;Raul G Nogueira,&nbsp;Jeremy L Rempel,&nbsp;Charlotte Zerna,&nbsp;Michael Tymianski,&nbsp;Michael D Hill,&nbsp;Mayank Goyal,&nbsp;Mohammed A Almekhlafi","doi":"10.1007/s00062-021-01123-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01123-0","url":null,"abstract":"<p><strong>Background: </strong>Successful reperfusion determines the treatment effect of endovascular thrombectomy. We evaluated stent-retriever characteristics and their relation to reperfusion in the ESCAPE-NA1 trial.</p><p><strong>Methods: </strong>Independent re-scoring of reperfusion grade for each attempt was conducted. The following characteristics were evaluated: stent-retriever length and diameter, thrombus position within stent-retriever, bypass effect, deployment in the superior or inferior MCA trunk, use of balloon guide catheter and distal access catheter. Primary outcome was successful reperfusion defined as expanded thrombolysis in cerebral infarction (eTICI) 2b-3 per attempt. The secondary outcome was successful reperfusion eTICI 2b-3 after the first attempt. Separate regression models for each stent-retriever characteristic and an exploratory multivariable modeling to test the impact of all characteristics on successful reperfusion were built.</p><p><strong>Results: </strong>Of 1105 patients in the trial, 809 with the stent-retriever use (1241 attempts) were included in the primary analysis. The stent-retriever was used as the first-line approach in 751 attempts. A successful attempt was associated with thrombus position within the proximal or middle third of the stent (OR 2.06; 95% CI: 1.24-3.40 and OR 1.92; 95% CI: 1.16-3.15 compared to the distal third respectively) and with bypass effect (OR 1.7; 95% CI: 1.07-2.72). Thrombus position within the proximal or middle third (OR 2.80; 95% CI: 1.47-5.35 and OR 2.05; 95% CI: 1.09-3.84, respectively) was associated with first-pass eTICI 2b-3 reperfusion. In the exploratory analysis accounting for all characteristics, bypass effect was the only independent predictor of eTICI 2b-3 reperfusion (OR 1.95; 95% CI: 1.10-3.46).</p><p><strong>Conclusion: </strong>The presence of bypass effect and thrombus positioning within the proximal and middle third of the stent-retriever were strongly associated with successful reperfusion.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"799-807"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficient Claustrum Segmentation in T2-weighted Neonatal Brain MRI Using Transfer Learning from Adult Scans.","authors":"Antonia Neubauer,&nbsp;Hongwei Bran Li,&nbsp;Jil Wendt,&nbsp;Benita Schmitz-Koep,&nbsp;Aurore Menegaux,&nbsp;David Schinz,&nbsp;Bjoern Menze,&nbsp;Claus Zimmer,&nbsp;Christian Sorg,&nbsp;Dennis M Hedderich","doi":"10.1007/s00062-021-01137-8","DOIUrl":"https://doi.org/10.1007/s00062-021-01137-8","url":null,"abstract":"<p><strong>Purpose: </strong>Intrauterine claustrum and subplate neuron development have been suggested to overlap. As premature birth typically impairs subplate neuron development, neonatal claustrum might indicate a specific prematurity impact; however, claustrum identification usually relies on expert knowledge due to its intricate structure. We established automated claustrum segmentation in newborns.</p><p><strong>Methods: </strong>We applied a deep learning-based algorithm for segmenting the claustrum in 558 T2-weighted neonatal brain MRI of the developing Human Connectome Project (dHCP) with transfer learning from claustrum segmentation in T1-weighted scans of adults. The model was trained and evaluated on 30 manual bilateral claustrum annotations in neonates.</p><p><strong>Results: </strong>With only 20 annotated scans, the model yielded median volumetric similarity, robust Hausdorff distance and Dice score of 95.9%, 1.12 mm and 80.0%, respectively, representing an excellent agreement between the automatic and manual segmentations. In comparison with interrater reliability, the model achieved significantly superior volumetric similarity (p = 0.047) and Dice score (p < 0.005) indicating stable high-quality performance. Furthermore, the effectiveness of the transfer learning technique was demonstrated in comparison with nontransfer learning. The model can achieve satisfactory segmentation with only 12 annotated scans. Finally, the model's applicability was verified on 528 scans and revealed reliable segmentations in 97.4%.</p><p><strong>Conclusion: </strong>The developed fast and accurate automated segmentation has great potential in large-scale study cohorts and to facilitate MRI-based connectome research of the neonatal claustrum. The easy to use models and codes are made publicly available.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"665-676"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39855217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signal Intensity Evaluation in the Dentate Nucleus and Subcortical Gray Matter : Effect of Several Administrations of Gadoterate Meglumine in Multiple Sclerosis.","authors":"Salem Hannoun,&nbsp;Gabriel Kocevar,&nbsp;Pekes Codjia,&nbsp;Delphine Maucort-Boulch,&nbsp;François Cotton,&nbsp;Sandra Vukusic,&nbsp;Françoise Durand-Dubief,&nbsp;Dominique Sappey-Marinier","doi":"10.1007/s00062-021-00995-6","DOIUrl":"https://doi.org/10.1007/s00062-021-00995-6","url":null,"abstract":"<p><strong>Purpose: </strong>Several studies reported gadolinium deposition in the dentate nuclei (DN) and the globus pallidus (GP) that was associated to linear GBCA administrations rather than macrocyclic. It is therefore imperative to evaluate and assess the safety of cumulative administration of gadoterate meglumine (macrocyclic). Thus, T1-weighted images (T1WI) of multiple sclerosis (MS) patients longitudinally followed for 4 years were retrospectively analyzed.</p><p><strong>Methods: </strong>In this study 44 patients, 10 with clinically isolated syndrome (CIS), 24 relapsing-remitting MS (RRMS) and 10 primary-progressive MS (PPMS) were examined every 6 months (first four scans) and then with a 1-year interval (last two scans). Image processing consisted in reorienting unenhanced T1WI to standard space, followed by B1 inhomogeneity correction. A patient-specific template was then generated to normalize T1WI signal intensity (SI) and segment the DN and subcortical GM structures. All structures were then transformed to each patient space in order to measure the SI in each region. The cerebellar peduncles (CP) and semi-oval (SO) white matter were then manually delineated and used as reference to calculate SI ratios in the DN and subcortical GM structures. A linear mixed-effect model was finally applied to longitudinally analyze SI variations.</p><p><strong>Results: </strong>The SI measurements performed in all structures showed no significant increases with the cumulative GBCA administration.</p><p><strong>Conclusion: </strong>This study showed no significant SI increases within the DN and subcortical GM structures of longitudinally followed MS patients even with the cumulative administration of the macrocyclic GBCA gadoterate meglumine.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"677-685"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00062-021-00995-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25403075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Endovascular Thrombectomy Alone vs. Bridging Thrombolysis for Patients with Acute Ischemic Stroke : A Meta-analysis.","authors":"Kyoung Min Jang,&nbsp;Hyun Ho Choi,&nbsp;Myoung-Jin Jang,&nbsp;Young Dae Cho","doi":"10.1007/s00062-021-01116-z","DOIUrl":"https://doi.org/10.1007/s00062-021-01116-z","url":null,"abstract":"<p><strong>Purpose: </strong>Although the current guidelines recommend bridging thrombolysis (BT) therapy, which is intravenous thrombolysis (IVT) followed by endovascular thrombectomy (EVT), for patients with acute ischemic stroke from large vessel occlusion (AIS-LVO), the effectiveness and safety of IVT remain controversial. We performed a meta-analysis to demonstrate the non-inferiority of direct EVT alone (DEVT) compared to BT for the efficacy and safety in patients with AIS-LVO who were eligible for IVT.</p><p><strong>Methods: </strong>The literature was searched in big databases between 1 January 1990 and 1 April 2021. The search included both randomized clinical trials (RCTs) and nonrandomized studies (NRSs) that compared DEVT with BT for patients with AIS-LVO who were eligible for IVT (time from stroke onset ≤ 4.5 h). Only NRSs with good intergroup variable matching were included in the study. Outcomes measured included 90-day functional independence, mortality, symptomatic intracranial hemorrhage (sICH), and successful recanalization. The noninferiority margin for risk difference was set at 5% from the literature review.</p><p><strong>Results: </strong>Three RCTs (n = 1094) and four NRSs (n = 1366) were included in the meta-analysis. There were 1227 patients (49.9%) in the DEVT group and 1233 patients (50.1%) in the BT group. A statistically significant noninferiority of DEVT compared to BT was concluded in 90-day functional independence, mortality and successful reperfusion. Even in the sICH rate, DEVT group showed a superiority (risk difference, -2%; 95% confidence interval, -4 to -0.002%).</p><p><strong>Conclusion: </strong>Evidence from RCTs and observational NRSs supports the use of DEVT (without IVT) as the first choice for treatment of patients with AIS-LVO within a time span of 4.5 h or less from stroke onset.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"603-613"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39615242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compressed SENSE in Pediatric Brain Tumor MR Imaging : Assessment of Image Quality, Examination Time and Energy Release.","authors":"Rieke L Meister,&nbsp;Michael Groth,&nbsp;Julian H W Jürgens,&nbsp;Shuo Zhang,&nbsp;Jan H Buhk,&nbsp;Jochen Herrmann","doi":"10.1007/s00062-021-01112-3","DOIUrl":"https://doi.org/10.1007/s00062-021-01112-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the image quality, examination time, and total energy release of a standardized pediatric brain tumor magnetic resonance imaging (MRI) protocol performed with and without compressed sensitivity encoding (C-SENSE). Recently introduced as an acceleration technique in MRI, we hypothesized that C‑SENSE would improve image quality, reduce the examination time and radiofrequency-induced energy release compared with conventional examination in a pediatric brain tumor protocol.</p><p><strong>Methods: </strong>This retrospective study included 22 patients aged 2.33-18.83 years with different brain tumor types who had previously undergone conventional MRI examination and underwent follow-up C‑SENSE examination. Both examinations were conducted with a 3.0-Tesla device and included pre-contrast and post-contrast T1-weighted turbo-field-echo, T2-weighted turbo-spin-echo, and fluid-attenuated inversion recovery sequences. Image quality was assessed in four anatomical regions of interest (tumor area, cerebral cortex, basal ganglia, and posterior fossa) using a 5-point scale. Reader preference between the standard and C‑SENSE images was evaluated. The total examination duration and energy deposit were compared based on scanner log file analysis.</p><p><strong>Results: </strong>Relative to standard examinations, C‑SENSE examinations were characterized by shorter total examination times (26.1 ± 3.93 vs. 22.18 ± 2.31 min; P = 0.001), reduced total energy deposit (206.0 ± 19.7 vs. 92.3 ± 18.2 J/kg; P < 0.001), and higher image quality (overall P < 0.001).</p><p><strong>Conclusion: </strong>C‑SENSE contributes to the improvement of image quality, reduction of scan times and radiofrequency-induced energy release relative to the standard protocol in pediatric brain tumor MRI.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"725-733"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39793432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The case against endovascular thrombectomy in neonates with arterial ischemic stroke.","authors":"Adam Kirton, Lori C Jordan, Darren B Orbach, Heather J Fullerton","doi":"10.1007/s00062-022-01153-2","DOIUrl":"10.1007/s00062-022-01153-2","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 1","pages":"581-582"},"PeriodicalIF":2.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47565597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early TICI 2b or Late TICI 3-Is Perfect the Enemy of Good?","authors":"F Flottmann,&nbsp;N van Horn,&nbsp;M E Maros,&nbsp;R McDonough,&nbsp;M Deb-Chatterji,&nbsp;A Alegiani,&nbsp;G Thomalla,&nbsp;U Hanning,&nbsp;J Fiehler,&nbsp;C Brekenfeld","doi":"10.1007/s00062-021-01048-8","DOIUrl":"https://doi.org/10.1007/s00062-021-01048-8","url":null,"abstract":"<p><strong>Background and purpose: </strong>A Thrombolysis in Cerebral Infarction (TICI) score of 3 has been established as therapeutic goal in endovascular therapy (EVT) for acute ischemic stroke; however, in the case of early TICI2b reperfusion, the question remains whether to stop the procedure or to continue in the pursuit of perfection (i.e., TICI 2c/3).</p><p><strong>Methods: </strong>A total of 6635 patients were screened from the German Stroke Registry. Patients who underwent EVT for occlusion of the middle cerebral artery (M1 segment), with final TICI score of 2b/3 were included. Multivariable logistic regression was performed with functional independence (modified Rankin Scale, mRS at day 90 of 0-2) as the dependent variable.</p><p><strong>Results: </strong>Of 1497 patients, 586 (39.1%) met inclusion criteria with a final TICI score of 2b and 911 (60.9%) with a TICI score of 3. Patients who achieved first-pass TICI3 showed highest odds of functional independence (Odds ratio [OR] 1.71, 95% confidence interval [95% CI] 1.18-2.47). Patients who achieved TICI2b with the second pass (OR 0.53, 95% CI 0.31-0.89) or with three or more passes (OR 0.44, 95% CI 0.27-0.70) had significantly worse clinical outcomes compared to first-pass TICI2b. TICI3 at the second pass was by trend better than first-pass TICI2b (OR 1.55, 95% CI 0.98-2.45), but TICI3 after 3 or more passes (OR 0.93, 95% CI 0.57-1.50) was not significantly different from first-pass TICI2b.</p><p><strong>Conclusion: </strong>First-pass TICI2b was superior to TICI2b after ≥ 2 retrievals and comparable to TICI3 at ≥ 3 retrievals. The potential benefit in outcome after achieving TICI3 following further retrieval attempts after first-pass TICI2b need to be weighed against the risks.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 2","pages":"353-360"},"PeriodicalIF":2.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00062-021-01048-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39124239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Cerebral Aneurysm Rupture in Mongolia.","authors":"Matthias Bechstein,&nbsp;Amarjargal Gansukh,&nbsp;Boldbat Regzengombo,&nbsp;Oyun Byambajav,&nbsp;Lukas Meyer,&nbsp;Michael Schönfeld,&nbsp;Helge Kniep,&nbsp;Uta Hanning,&nbsp;Gabriel Broocks,&nbsp;Tserenchunt Gansukh,&nbsp;Jens Fiehler","doi":"10.1007/s00062-021-01051-z","DOIUrl":"https://doi.org/10.1007/s00062-021-01051-z","url":null,"abstract":"<p><strong>Purpose: </strong>Identification of country-specific demographic, medical, lifestyle, and geoenvironmental risk factors for cerebral aneurysm rupture in the developing Asian country of Mongolia. First-time estimation of the crude national incidence of aneurysmal subarachnoid hemorrhage (aSAH).</p><p><strong>Methods: </strong>A retrospective analysis of all intracranial digital subtraction angiographies (DSA) acquired in Mongolia during the 2‑year period 2016-2017 (1714 examinations) was performed. During this period, DSA was used as primary diagnostic imaging modality for acute severe neurological symptoms in the sole hospital nationwide dedicated to neurological patients. The catchment area of the hospital included the whole country. Patients with incidental and ruptured aneurysms were reviewed with respect to their medical history and living conditions. The data was used to install a Mongolian aneurysm registry.</p><p><strong>Results: </strong>The estimated annual crude incidence of cerebral aneurysm rupture was 6.71 for the country of Mongolia and 14.53 per 100,000 persons for the capital region of Ulaanbaatar. Risk factors common in developed countries also applied for the Mongolian population: A medical history of hypertension, smoking or the presence of multiple aneurysms led to a higher relative risk of rupture. In contrast, female gender was not associated with a higher risk in this national cohort. Males pursuing a traditional nomadic living may exhibit a specifically high risk of rupture.</p><p><strong>Conclusion: </strong>Disease management of over 200 individuals/year with aSAH constitutes a socioeconomic burden in Mongolia. Efforts to raise awareness of the risk factors hypertension and smoking among the Mongolian population are desirable. Measures to improve the nationwide availability of modern neurovascular treatment options are currently under consideration.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 2","pages":"499-506"},"PeriodicalIF":2.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00062-021-01051-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39124240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"neuroRAD 2022: Precision. Individualized","authors":"P. Schramm, C. Zimmer","doi":"10.1007/s00062-022-01163-0","DOIUrl":"https://doi.org/10.1007/s00062-022-01163-0","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 1","pages":"323 - 324"},"PeriodicalIF":2.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48975986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Pelvis Opacification on Postmyelography Computed Tomography as an Indicator for Cerebrospinal Fluid Loss in Spontaneous Intracranial Hypotension.","authors":"Eike I Piechowiak,&nbsp;Laura Bär,&nbsp;Levin Häni,&nbsp;Mattia Branca,&nbsp;Johannes Kaesmacher,&nbsp;Pasquale Mordasini,&nbsp;Andreas Raabe,&nbsp;Christian T Ulrich,&nbsp;Jan Gralla,&nbsp;Jürgen Beck,&nbsp;Tomas Dobrocky","doi":"10.1007/s00062-021-01042-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01042-0","url":null,"abstract":"<p><strong>Purpose: </strong>To assess early renal pelvis opacification on postmyelography computed tomography (CT) as a marker for cerebrospinal fluid (CSF) loss in patients with spontaneous intracranial hypotension (SIH).</p><p><strong>Methods: </strong>The SIH patients referred to our hospital between January 2012 and May 2018 were retrospectively reviewed and divided into 2 groups based on the presence of spinal longitudinal extrathecal CSF collection (SLEC): (1) SLEC(+) with, and (2) SLEC(-) without proof of SLEC on multimodal imaging. Non-SIH patients (n = 20) undergoing CT myelography served as controls. The renal pelvis density on postmyelography CT was measured in all patients. Mean difference in renal pelvis density between the groups was calculated.</p><p><strong>Results: </strong>In total, 111 SIH patients (mean age 48 ± 13 years; 60% female) were included, 71 (64%) SLEC(+) and 40 (36%) SLEC(-). The adjusted renal pelvis density in the SLEC(+), SLEC(-), and the non-SIH group was 108 Hounsfield unit (HU), 83 HU, and 32 HU, respectively, resulting in a significant difference between SLEC(+) vs. control group 1 (75 HU, p < 0.001), SLEC(-) vs. control group 1 (50 HU, p < 0.001), and a tendency for higher density in SLEC(+) than SLEC(-) (25 HU, p = 0.16).</p><p><strong>Conclusion: </strong>Increased renal pelvis opacification on postmyelography CT was observed in SIH patients, even in the absence of a CSF leak or a CSF venous fistula, when compared to non-SIH patients. Although the provenance of early renal opacification in SLEC (-) SIH patients remains unclear, our results suggest that it may be a surrogate for increased spinal CSF resorption via spinal arachnoid granulations and along spinal nerve sheaths occult to direct imaging.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 2","pages":"529-536"},"PeriodicalIF":2.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00062-021-01042-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39038597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}