PT  - JOURNAL ARTICLE
AU  - Madhavan, Ajay A.
AU  - Kranz, Peter G.
AU  - Brinjikji, Waleed
AU  - Mark, Ian T.
AU  - Amrhein, Timothy J.
TI  - Photon-Counting CT Myelography for the Detection of Spinal CSF Leaks
AID  - 10.3174/ajnr.A8736
DP  - 2025 Apr 01
TA  - American Journal of Neuroradiology
PG  - 846--846
VI  - 46
IP  - 4
4099  - http://www.ajnr.org/content/46/4/846.short
4100  - http://www.ajnr.org/content/46/4/846.full
SO  - Am. J. Neuroradiol.2025 Apr 01; 46
AB  - Photon-counting CT myelography is a relatively recently described technique for the detection of spinal CSF leaks in patients with spontaneous intracranial hypotension.1⇓-3 In this Video, we outline the fundamental procedural techniques used in CT myelography for CSF leak detection, as well as specific advantages and reconstruction options available when using photon-counting CT.4⇓⇓-7 Additionally, we show examples demonstrating the typical appearance of common spinal CSF leaks detected on photon-counting CT myelography, which mainly include dural tears and CSF-venous fistulas.8 This Video draws on technical insights gleaned from a multi-institutional perspective, while specific techniques continue to vary at different centers. Future refinement of photon-counting CT myelographic techniques at multiple centers will be helpful to maximally leverage this nascent technology.