MY CONTENT

Type 1 CSF leaks are commonly associated with ventral predominant epidural fluid. On 2D T2-weighted and STIR images, CSF-flow artifact in the anterior subarachnoid space and/or the adjacent epidural fluid collection at the level of the dural defect is caused by CSF-flow and may permit accurate prediction of the site of the CSF leak noninvasively.

This review discusses the 3 key MRI sequences for ARIA monitoring and standardized imaging protocols and provides imaging recommendations for 3 key patient scenarios. All patients on anti-amyloid immunotherapy should have T2* gradient-recalled echo (to evaluate for ARIA-H), 2D or 3D T2 FLAIR (to evaluate for ARIA-E), and DWI (to differentiate ARIA-E from acute ischemia). Patient imaging scenarios are 1) baseline dementia diagnosis/treatment enrollment evaluation, 2) asymptomatic ARIA monitoring, and 3) evaluation of the symptomatic patient on anti-amyloid immunotherapy.