Prof Cerebrospinal CNS-Leaks: State of the Art in Imaging Diagnosis with Special Focus on Intrathecal MRI Paramagnetic Contrast Agents Procedures

MR imaging has proved invaluable in anatomic depiction of the cerebrospinal fluid (CSF) spaces and the surrounding neural and non-neural tissue, although there are still some clinical situations (i.e., cases of CSF-flow alterations, communicating or non-communicating cyst masses bordering CSF pathways, or craniospinal CSF leaks) in which further imaging tests may be required for a definitive diagnosis. This paper will review the state-of-the-art imaging in these processes, including Radionuclide Cisternography, plain Computed Tomography (CT) and enhanced-CT Cisternography/ myelography, as well as Magnetic Resonance Imaging (MRI) and contrast-enhanced Cisternography/myelography, emphasizing the latest CT and MR imaging refinement advances and proposing tailored specific approaches for two well-established clinical syndromes, namely CSF rhinorrhea and intracranial hypotension syndrome.