All Pleural Effusions Are Not Created Equal

摘要

Pleural effusions have a multitude of causes. There are few instances when nuclear medicine has a direct role in establishing the cause. One includes the development of a thecal-pleural fistula. Generally, computed tomographic myelography has largely supplanted radionuclide cisternography to demonstrate these fistulae. However, in cases of intermittent or small cerebrospinal fluid leaks, radionuclide cisternography can be helpful in identifying these defects because of its greater visibility within the pleural space. The authors report a case of a thecal-pleural fistula after a remote thoracoscopic discectomy diagnosed with Tc-99m DPTA cisternography and computed tomographic myelography.