SPECT/CT as Gatekeeper for Extrathecal Administration on 99m Tc-DTPA Cisternography

Area of Science:

• Neurology
• Radiology
• Nuclear Medicine

Background:

• Spontaneous intracranial hypotension results from cerebrospinal fluid (CSF) volume loss.
• Cisternography is a key diagnostic tool for identifying CSF leaks.

Purpose of the Study:

• To illustrate the importance of correct radiopharmaceutical administration in cisternography for diagnosing CSF leaks.
• To highlight the role of SPECT/CT in preventing misdiagnosis of spontaneous intracranial hypotension.

Main Methods:

• A case study of a 32-year-old woman with suspected CSF leakage and orthostatic headaches.
• Two cisternography procedures were performed, with the first requiring re-evaluation.
• Retrospective review of SPECT/CT images was utilized for accurate diagnosis.

Main Results:

• The initial cisternography was misinterpreted, leading to a potential misdiagnosis.
• A subsequent review of SPECT/CT images confirmed the correct diagnosis.
• Proper radiopharmaceutical administration and SPECT/CT review are vital for accurate diagnosis.

Conclusions:

• This case underscores the necessity of verifying correct radiopharmaceutical administration in cisternography.
• SPECT/CT imaging plays a critical role in avoiding diagnostic errors in spontaneous intracranial hypotension.
• Accurate diagnosis of CSF leaks relies on meticulous procedural execution and review.