Dissimilarity between CT-myelography and RI-cisternography findings in 41 patients with whiplash-associated disorders

  • HASHIZUME Keiji
    Pain center, Nara Medical University Hospital Pain center, Nara Medical University Hospital
  • WATANABE Keisuke
    Pain center, Nara Medical University Hospital Pain center, Nara Medical University Hospital
  • KINOSHITA Masako
    Department of Anesthesiology, Nara Medical University Department of Anesthesiology, Nara Medical University
  • FUJIWARA Aki
    Department of Anesthesiology, Nara Medical University Department of Anesthesiology, Nara Medical University
  • FURUYA Hitoshi
    Department of Anesthesiology, Nara Medical University Department of Anesthesiology, Nara Medical University

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Other Title
  • むちうち関連障害41症例における髄液漏出の検索―RI脳槽造影とCT脊髄造影の比較
  • ムチ ウチ カンレン ショウガイ 41 ショウレイ ニ オケル ズイエキ ロウシュツ ノ ケンサク : RI ノウソウゾウエイ ト CT セキズイゾウエイ ノ ヒカク

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Abstract

Some physicians in Japan have insisted that whiplash-associated disorders (WADs) are caused by traumatic cerebrospinal fluid (CSF) leak. Several studies have reported that CSF leak was detected on radioisotope cisternography (RIC) in the lumbosacral region of WAD patients. However, RIC may create false positives by detecting nerve roots or cysts as a CSF leak, whereas the appearance of contrast medium in the epidural space on computerized tomography myelography (CTM) demonstrates a CSF leak directly. We compared the findings of RIC and CTM in 41 patients with WAD. As a result, paraspinal RI accumulation (PSA) was observed in 20 patients, and was located in the lumbosacral region in 19 patients on RIC. In contrast, no epidural collection was observed on CTM, whose findings revealed that root sleeves and cystic structures were observed at the locations in which PSA was noted on RIC. The results indicated that traumatic CSF leak was not observed on the CTM in WAD patients, in which a CSF leak was suspected on the RIC.

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