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Abstract #4718

MR myelography with intrathecal gadolinium: novel use of 3D T1 VIBE Dixon sequences to depict a spinal cerebrospinal fluid leak

Marco Borri1, Jane Ansell1, David Ryan2, Ruth Newport2, Sithabile Mahlokozera2, Daniel J Scoffings3, and Lalani Carlton Jones2,4
1Medical Engineering and Physics, King's College Hospital NHS Foundation Trust, London, United Kingdom, 2Neuroradiology, King's College Hospital NHS Foundation Trust, London, United Kingdom, 3Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom, 4Radiology, Guy's & St Thomas' Hospitals NHS Foundation Trust, London, United Kingdom

Synopsis

Keywords: Neurofluids, Neurofluids, cerebrospinal fluid leak; MR myelography; intrathecal gadolinium; spontaneous intracranial hypotension; Dixon fat suppression

Motivation: Regarding fat-suppressed 3D T1-wighted sequences employed for cerebrospinal fluid (CSF) leak detection, in the literature there is a paucity of details on the fat suppression technique employed and a lack of standardisation or discussion on the optimization of the technical aspects.

Goal(s): Optimise 3D T1-wighted sequences that a) achieve complete fat suppression around the spinal canal and b) are feasible to implement on a wide range of scanners.

Approach: Develop MR myelography sequences at 1.5T considering available sequence and fat suppression options.

Results: Superior performance of Dixon fat suppression. Optimised VIBE-DIXON sequences detect leakage of contrast-opacified CSF in a clinical case.

Impact: This study supports 3D spoiled gradient echo sequences with Dixon fat suppression as a reliable option for CSF leak assessment in clinical settings.

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