Incidence and clinical significance of epidural fluid signal on spinal magnetic resonance imaging after image-guided lumbar puncture in adults

Authors

Eric M. Christiansen, Department of Radiology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States of America.
Paul Kang, Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, United States of America.
Jeremy N. Hughes, Department of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States of America. Electronic address: Neuropub@barrowneuro.org.Follow

Document Type

Article

Abstract

PURPOSE: We determined the incidence of epidural fluid signal on spinal magnetic resonance imaging (MRI) after image-guided lumbar puncture (LP) in adults. We correlated those imaging findings with clinical status. METHODS: We searched our institution's medical records from January 2013 through April 2020 to identify adult patients who underwent image-guided LP and postdural puncture MRI. We examined the incidence of epidural fluid signal intensity in adults after image-guided dural puncture, characterized its imaging features, and evaluated its associated clinical factors. RESULTS: Of 91 patients who underwent image-guided dural puncture and subsequent spinal MRI within 7 days, 18 (20%) demonstrated epidural fluid signal on postdural puncture MRI. Univariate analysis showed that larger needle size correlated with signal presence (4/8 [50%] LP with a 20-gauge needle vs 13/82 [16%] with a 22-gauge needle, P = 0.03). The odds of observing epidural fluid signal on postdural puncture MRI decreased by 8% per 1-year increase in age (P < 0.001). Postdural puncture symptoms did not differ between those with and without epidural fluid signal intensity. CONCLUSION: Epidural fluid signal on MRI in adults may be an incidental finding more commonly observed in younger patients after dural puncture with larger needles, without a significant correlation with symptomatology.

Medical Subject Headings

Adult; Blood Patch, Epidural; Humans; Incidence; Magnetic Resonance Imaging (adverse effects); Needles (adverse effects); Post-Dural Puncture Headache (epidemiology, etiology); Spinal Puncture (adverse effects)

Publication Date

6-1-2022

Publication Title

Clinical imaging

E-ISSN

1873-4499

Volume

86

First Page

20

Last Page

24

PubMed ID

35316620

Digital Object Identifier (DOI)

10.1016/j.clinimag.2022.03.010

Recommended Citation

Christiansen, Eric M.; Kang, Paul; and Hughes, Jeremy N., "Incidence and clinical significance of epidural fluid signal on spinal magnetic resonance imaging after image-guided lumbar puncture in adults" (2022). Neuroradiology. 7.
https://scholar.barrowneuro.org/neuroradiology/7