원저 : 자발생 두개내 저압 환자의 방사성 동위원소 뇌조조영술 소견 ( Radionuclide Cisternographic Findings in Patients with Spontaneous Intracranial Hypotension ) () |
Author |
정동진(Dong Jin Jung),김재승(Jae Seung Kim),류진숙(Jin Sook Ryu),신중우(Jung Woo Shin),임주혁(Joo Hyuk Im),이명종(Myoung Chong Lee),정선주(Sun Joo Jung),문대혁(Dae Hyuk Moon),이희경(Hee Kyung Lee), |
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Affiliation |
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Abstract |
Purpose: Radionuclide cisternography may be helpful in
understanding pathophysiology of postural headache and
low CSF pressure in patients with spontaneous
intracranial hypotension. The purpose of this study was
to characterize radionuclide cisternographic findings
of spontaneous intracranial hypotension. Materials and
Methods: The study population consists of 15 patients
with spontaneous intracranial hypotension. Diagnosis
was based on their clinical symptoms and results of
lumbar puncture. All patients underwent radionuclide
cisternography following injection of 111 to 222 MBq of
Tc-99m DTPA into the lumbar subarachnoid space.
Sequential images were obtained between 1/2 hour and 24
hour after the injection of Tc-99m DTPA. Radioactivity
of the bladder, soft tissue uptake, migration of
radionuclide in the subarachnoid space, and extradural
leakage of radionuclide were evaluated according to the
scan time. Results: Radionuclide cisternogram showed
delayed migration of radionuclide into the cerebral
convexity (14/15), increased soft tissue uptake
(11/15), and early visualization of bladder activity at
30 min (6/10) and 2 hr (13/13). Cisternography also
demonstrated leakage site of CSF in 4 cases and 2 of
these were depicted at 30 min. Epidural blood patch was
done in 11 patients and headache was improved in all
cases. Conclusion: The characterstic findings of
spontaneous intracranial hypotension were delayed
migration of radionuclide and early visualization of
the soft tissue and bladder activity. These
scintigraphic findings suggest that CSF leakage rather
than increased CSF absorption or decreased production
may be the main pathophysiology of spontaneous
intracranial hypotension. Early and multiple imaging
including the bladder and soft tissue is required to
observe the entire dynamics of radionuclide migration. |
Keyword |
Tc-99m DTPA, Radionuclide Cisternography, Spontaneous Intracranial Hypotension |
Full text Article |
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