{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:51:28Z","timestamp":1788285088600,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1129","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>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\u2009month MRI as the end point.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>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 \u2265three 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%\u2009CI: 3.47\u2013972.54; p = 0.005) and \u2265three numbers of spinal CSF leakage (OR: 15.13; 95%\u2009CI: 1.45\u2013159.06; p = 0.023) were associated with EBP failure. Between these variables, \u2265three 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%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20210841","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T18:34:10Z","timestamp":1636655650000},"source":"Crossref","is-referenced-by-count":5,"title":["Magnetic resonance imaging predicted the therapeutic response of patients with spinal cerebrospinal fluid leakage undergoing targeted epidural blood patch"],"prefix":"10.1093","volume":"95","author":[{"given":"Hung-Chieh","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiology, Taichung Veterans General Hospital , Taichung , Taiwan"},{"name":"School of Medicine, National Yang-Ming Chiao-Tung University , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyh-wen","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Taichung Veterans General Hospital , Taichung , Taiwan"},{"name":"College of Medicine, China Medical University , Taichung , Taiwan"},{"name":"College of Medicine, National Chung Hsing University , Taichung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Cheng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Taichung Veterans General Hospital , Taichung , Taiwan"},{"name":"Department of Financial Engineering, Providence University , Taichung , Taiwan"},{"name":"Department of Data Science and Big Data Analytics, Providence University , Taichung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine, National Yang-Ming Chiao-Tung University , Taipei , Taiwan"},{"name":"Department of Neurology, Taichung Veterans General Hospital , Taichung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-0368","authenticated-orcid":false,"given":"Chieh-Lin","family":"Teng","sequence":"additional","affiliation":[{"name":"College of Medicine, National Chung Hsing University , Taichung , Taiwan"},{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital , Taichung , Taiwan"},{"name":"School of Medicine, Chung-Shan University , Taichung , Taiwan"},{"name":"Department of Life Science, Tunghai University , Taichung , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,22]]},"reference":[{"key":"2024050310484322200_b1","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.3174\/ajnr.A5134","article-title":"Quantitative measurement of CSF in patients with spontaneous intracranial hypotension","volume":"38","author":"Chen","year":"2017","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050310484322200_b2","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.nic.2019.07.006","article-title":"Spontaneous intracranial hypotension: pathogenesis, diagnosis, and treatment","volume":"29","author":"Kranz","year":"2019","journal-title":"Neuroimaging Clin N Am"},{"key":"2024050310484322200_b3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3988\/jcn.2020.16.1.1","article-title":"Predictors of the response to an epidural blood patch in patients with spinal leakage of cerebrospinal fluid","volume":"16","author":"Kanno","year":"2020","journal-title":"J Clin Neurol"},{"key":"2024050310484322200_b4","doi-asserted-by":"crossref","first-page":"649","DOI":"10.3174\/ajnr.A0920","article-title":"Detection of CSF leak in spinal CSF leak syndrome using MR myelography: correlation with radioisotope cisternography","volume":"29","author":"Yoo","year":"2008","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050310484322200_b5","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1212\/WNL.43.5.919","article-title":"MRI changes in intracranial hypotension","volume":"43","author":"Pannullo","year":"1993","journal-title":"Neurology"},{"key":"2024050310484322200_b6","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.3174\/ajnr.A0621","article-title":"The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain","volume":"28","author":"Farb","year":"2007","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050310484322200_b7","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1212\/WNL.55.4.573","article-title":"False pituitary tumor in CSF leaks","volume":"55","author":"Mokri","year":"2000","journal-title":"Neurology"},{"key":"2024050310484322200_b8","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1212\/WNL.56.12.1746","article-title":"The Monro-Kellie hypothesis: applications in CSF volume depletion","volume":"56","author":"Mokri","year":"2001","journal-title":"Neurology"},{"key":"2024050310484322200_b9","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/AAP.0b013e3181b493e9","article-title":"Meningeal (postdural) puncture headache, unintentional dural puncture, and the epidural blood patch: a national survey of United States practice","volume":"34","author":"Harrington","year":"2009","journal-title":"Reg Anesth Pain Med"},{"key":"2024050310484322200_b10","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1136\/jnnp.2007.122879","article-title":"Epidural blood patch in post dural puncture headache: a randomised, observer-blind, controlled clinical trial","volume":"79","author":"van Kooten","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2024050310484322200_b11","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1111\/head.12149","article-title":"Spontaneous low pressure, low CSF volume headaches: spontaneous CSF leaks","volume":"53","author":"Mokri","year":"2013","journal-title":"Headache"},{"key":"2024050310484322200_b12","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1212\/WNL.57.10.1921","article-title":"The efficacy of epidural blood patch in spontaneous CSF leaks","volume":"57","author":"Sencakova","year":"2001","journal-title":"Neurology"},{"key":"2024050310484322200_b13","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jcma.2016.02.013","article-title":"Patterns of cerebrospinal fluid (CSF) distribution in patients with spontaneous intracranial hypotension: assessed with magnetic resonance myelography","volume":"80","author":"Chen","year":"2017","journal-title":"J Chin Med Assoc"},{"key":"2024050310484322200_b14","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/bja\/83.5.807","article-title":"Posterior epidural space depth: safety of the loss of resistance and hanging drop techniques","volume":"83","author":"Hoffmann","year":"1999","journal-title":"Br J Anaesth"},{"key":"2024050310484322200_b15","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.spinee.2005.12.026","article-title":"Intracranial hypotension with spinal pathology","volume":"6","author":"Inamasu","year":"2006","journal-title":"Spine J"},{"key":"2024050310484322200_b16","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2253-13-35","article-title":"Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?","volume":"13","author":"Sakurai","year":"2013","journal-title":"BMC Anesthesiol"},{"issue":"Pt 6","key":"2024050310484322200_b17","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1093\/brain\/awv016","article-title":"Cerebrospinal fluid leakage and headache after lumbar puncture: a prospective non-invasive imaging study","volume":"138","author":"Wang","year":"2015","journal-title":"Brain"},{"key":"2024050310484322200_b18","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s13760-019-01166-8","article-title":"Spontaneous intracranial hypotension: review and expert opinion","volume":"120","author":"Ferrante","year":"2020","journal-title":"Acta Neurol Belg"},{"key":"2024050310484322200_b19","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1093\/brain\/aww328","article-title":"Factors predicting response to the first epidural blood patch in spontaneous intracranial hypotension","volume":"140","author":"Wu","year":"2017","journal-title":"Brain"},{"key":"2024050310484322200_b20","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1212\/01.WNL.0000144339.34733.E9","article-title":"Early epidural blood patch in spontaneous intracranial hypotension","volume":"63","author":"Berroir","year":"2004","journal-title":"Neurology"},{"key":"2024050310484322200_b21","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1212\/WNL.0b013e318212ab43","article-title":"Spontaneous intracranial hypotension: efficacy of radiologic targeting vs blind blood patch","volume":"76","author":"Cho","year":"2011","journal-title":"Neurology"},{"key":"2024050310484322200_b22","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00234-021-02766-z","article-title":"Spontaneous intracranial hypotension: diagnostic and therapeutic workup","volume":"63","author":"Luetzen","year":"2021","journal-title":"Neuroradiology"},{"key":"2024050310484322200_b23","doi-asserted-by":"crossref","first-page":"2286","DOI":"10.1001\/jama.295.19.2286","article-title":"Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension","volume":"295","author":"Schievink","year":"2006","journal-title":"JAMA"},{"key":"2024050310484322200_b24","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.3174\/ajnr.A6592","article-title":"Spine MRI in spontaneous intracranial hypotension for CSF leak detection: Nonsuperiority of intrathecal gadolinium to heavily T2-weighted Fat-Saturated sequences","volume":"41","author":"Dobrocky","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024050310484322200_b25","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1001\/jamaneurol.2021.2868","article-title":"Computed tomography vs heavily T2-weighted magnetic resonance myelography for the initial evaluation of patients with spontaneous intracranial hypotension","volume":"78","author":"Tay","year":"2021","journal-title":"JAMA Neurol"},{"key":"2024050310484322200_b26","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1212\/WNL.0b013e3181c3fd99","article-title":"Heavily T2-weighted MR myelography vs CT myelography in spontaneous intracranial hypotension","volume":"73","author":"Wang","year":"2009","journal-title":"Neurology"},{"key":"2024050310484322200_b27","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","year":"2019","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/95\/1129\/20210841\/57395247\/bjr.20210841.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/95\/1129\/20210841\/57395247\/bjr.20210841.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T10:51:36Z","timestamp":1714733496000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20210841\/7451472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,22]]},"references-count":27,"journal-issue":{"issue":"1129","published-online":{"date-parts":[[2021,11,22]]},"published-print":{"date-parts":[[2022,1,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20210841","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,1,1]]},"published":{"date-parts":[[2021,11,22]]},"article-number":"20210841"}}