Incidence and clinical significance of epidural fluid signal on spinal magnetic resonance imaging after image-guided lumbar puncture in adults
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)
Digital Object Identifier (DOI)
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.