Di-san junyi daxue xuebao (May 2019)
Diagnostic value of 3D-Cube T2 sequence combined with plain CT scan of the skull base for cerebrospinal fluid rhinorrhea
Abstract
Objective To evaluate the diagnostic value of magnetic resonance 3D-Cube T2 sequence, plain CT scan of the skull base and their combination for cerebrospinal fluid (CSF) rhinorrhea and assess the performance of these 2 modalities combined in improving the detection rate of CSF rhinorrhea and in localization of CSF leakage. Methods We retrospectively analyzed the imaging data of 22 patients with CSF rhinorrhea confirmed surgically or clinically in our hospital from February, 2016 to October, 2018. All the patients underwent routine cranial magnetic resonance imaging (MR) plain scan and 3D-Cube T2 sequence on the sagittal or coronal plane; 13 of the patients also underwent plain CT scan of the skull base, and the detection rate of CSF rhinorrhea by combining the two modalities was assessed. Results Of the 22 patients with CSF rhinorrhea, 17 (77.3%) were diagnosed based on findings by 3D-Cube T2 sequence; the diagnosis was established in 9 (69.2%) out of the 13 patients undergoing plain CT scan of the skull base. In the 13 cases having both 3D-Cube T2 sequence examination and plain CT scan of the skull base, the detection rate of CSF rhinorrhea was 92.3% (12/13). A total of 21 suspicious leaks were found by 3D-Cube T2 sequence combined with plain CT scan, including 9 in the upper wall of the ethmoid sinus and the superior nasal meatus, 11 in the frontal sinus, 3 in the sphenoid sinus and the parasellar region, and 2 in the ethmoid plate. Conclusion MR 3D-Cube T2 sequence can show the precise location of CSF leak through post-processing multi-plane reconstruction. Plain CT scan of the skull base allows observation of the interruption of bone tissue continuity, separation in the sinus or nasal cavity, and brain tissue herniation into the bone defect. The combination of these 2 modalities can improve the detection rate of CSF rhinorrhea.
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