MR myelography with intrathecal gadolinium: novel use of 3D T1 VIBE Dixon sequences to depict a spinal cerebrospinal fluid leak

Motivation: Regarding fat-suppressed 3D T1-wighted sequences employed for cerebrospinal fluid (CSF) leak detection, in the literature there is a paucity of details on the fat suppression technique employed and a lack of standardisation or discussion on the optimization of the technical aspects. Goal(s): Optimise 3D T1-wighted sequences that a) achieve complete fat suppression around the spinal canal and b) are feasible to implement on a wide range of scanners. Approach: Develop MR myelography sequences at 1.5T considering available sequence and fat suppression options. Results: Superior performance of Dixon fat suppression. Optimised VIBE-DIXON sequences detect leakage of contrast-opacified CSF in a clinical case. Impact: This study supports 3D spoiled gradient echo sequences with Dixon fat suppression as a reliable option for CSF leak assessment in clinical settings.