{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:25:55Z","timestamp":1793946355317,"version":"4.8.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,5,21]],"date-time":"2023-05-21T00:00:00Z","timestamp":1684627200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,5,21]],"date-time":"2023-05-21T00:00:00Z","timestamp":1684627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Presented here is a strategy of sequential lateral decubitus digital subtraction myelography (LDDSM) followed closely by lateral decubitus CT (LDCT) to facilitate cerebrospinal fluid (CSF)\u2013venous fistula (CVF) localization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This is a retrospective analysis of patients referred to our institution for evaluation of CSF leak. Patients with Type 1 and Type 2 leaks, and those not displaying MR brain stigmata of intracranial hypotension were excluded. All patients underwent consecutive LDDSM and LDCT. If the CVF was not localized on the first LDDSM\u2013LDCT pair the patient returned for contralateral examinations. Images were reviewed for CVF and for accumulation of contrast within the renal pelvises expressed as a renal pelvis contrast score (RPCS) in Hounsfield units (HU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-two patients were included in this study. In 21 of 22 patients (95%) a CVF was identified yielding an RPCS for the LDDSM\u2013LDCT pair ipsilateral to the CVF ranging from 71 to 423 with an average of 146 HU. An RPCS of the negative side LDDSM\u2013LDCT pair contralateral to a CVF was available in 8 patients and averaged 51 HU. In 4 patients the initial bilateral LDDSM\u2013LDCT pairs did not reveal the location of the CVF however in 3 of these 4 cases the CVF was revealed on a third LDDSM repeated ipsilateral to the higher RPCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The strategy of sequential LDDSM\u2013LDCT coupled with evaluation of renal accumulation of contrast agent appears to improve the rate of CVF localization and warrants further evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199231172627","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:18:42Z","timestamp":1684714722000},"page":"457-463","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Spontaneous intracranial hypotension due to CSF\u2013venous fistula: Evaluation of renal accumulation of contrast following decubitus myelography and maintained decubitus CT to improve fistula localization"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7770-3762","authenticated-orcid":false,"given":"Richard I","family":"Farb","sequence":"first","affiliation":[{"name":"Department of Diagnostic Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean T","family":"O\u2019Reilly","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everardus J","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip W","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M","family":"Massicotte","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine","family":"Hoydonckx","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7182-5112","authenticated-orcid":false,"given":"Patrick J","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.6.SPINE19487"},{"key":"e_1_3_2_3_2","first-page":"745","article-title":"Spontaneous intracranial hypotension: a systematic imaging approach for CSF leak localization and management based on MRI and digital subtraction myelography","volume":"40","author":"Farb RI","year":"2019","unstructured":"Farb RI, Nicholson PJ, Peng PW, et al. Spontaneous intracranial hypotension: a systematic imaging approach for CSF leak localization and management based on MRI and digital subtraction myelography. AJNR Am J Neuroradiol 2019; 40: 745\u2013753.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000639"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.21.26182"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011522"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6844"},{"key":"e_1_3_2_8_2","first-page":"754","article-title":"Decubitus CT myelography for detecting subtle CSF leaks in spontaneous intracranial hypotension","volume":"40","author":"Kranz PG","year":"2019","unstructured":"Kranz PG, Gray L, Amrhein TJ. Decubitus CT myelography for detecting subtle CSF leaks in spontaneous intracranial hypotension. AJNR Am J Neuroradiol 2019; 40: 754\u2013756.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.4921"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6368"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5934"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-021-01042-0"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6393"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000001084"},{"key":"e_1_3_2_15_2","first-page":"1754","article-title":"Respiratory phase affects the conspicuity of CSF-venous fistulas in spontaneous intracranial hypotension","volume":"41","author":"Amrhein TJ","year":"2020","unstructured":"Amrhein TJ, Gray L, Malinzak MD, et al. Respiratory phase affects the conspicuity of CSF-venous fistulas in spontaneous intracranial hypotension. 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