Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base.
Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base.
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CT和MRI在颅底多个骨折诱导的脑脊髓泄漏诊断中的比较。
DOI：
10.2478/v10019-011-0007-6
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发表时间：
2011-06
影响因子：
2.4
通讯作者：
Xu L
中科院分区：
文献类型：
--
作者：
Wang X;Xu M;Liang H;Xu L
多发性颅底骨折和脑脊液漏是脑外伤常见的并发症，需要手术修复。但由于严重创伤后颅底骨折的复杂性，术前影像学定位一直是一个困难的问题。多排螺旋CT和MRI是目前广泛应用于临床的诊断方法。比较多排螺旋CT脑池造影与MRI脑池造影诊断脑脊液漏的准确性。本研究共纳入23例脑外伤后多发性颅底骨折患者。回顾性分析影像学和手术资料。64-12例行CT（mm/row）扫描及三维重建，11例行MR平扫及脑池造影。由2名神经放射科经验丰富的医生诊断脑脊液漏的位置。所有患者均行手术治疗。在手术过程中确认并修复了脑脊液漏位置。当术后无脑脊液漏时，认为结果准确。12例CT扫描中9例术前诊断准确，均与手术探查结果相符。2例患者多发骨折，CT无法确认位置，1例患者漏诊。MRI检查11例中10例术前诊断准确。MRI脑池造影在多发性颅底骨折的诊断中比多排CT扫描更先进。两种检查方法的结合可提高活动性脑脊液漏的诊断率。
Multiple basilar skull fracture and cerebrospinal leak are common complications of traumatic brain injury, which required a surgical repair. But due to the complexity of basilar skull fracture after severe trauma, preoperatively an exact radiological location is always difficult. Multi-row spiral CT and MRI are currently widely applied in the clinical diagnosis. The present study was performed to compare the accuracy of cisternography by multi-row spiral CT and MRI in the diagnosis of cerebrospinal leak. A total of 23 patients with multiple basilar skull fracture after traumatic brain injury were included. The radiological and surgical data were retrospectively analyzed. 64-row CT (mm/row) scan and three-dimensional reconstruction were performed in 12 patients, while MR plain scan and cisternography were performed in another 11 patients. The location of cerebrospinal leak was diagnosed by 2 experienced physicians majoring neurological radiology. Surgery was performed in all patients. The cerebrospinal leak location was confirmed and repaired during surgery. The result was considered as accurate when cerebrospinal leak was absent after surgery. According to the surgical exploration, the preoperative diagnosis of the active cerebrospinal leak location was accurate in 9 out of 12 patients with CT scan. The location could not be confirmed by CT because of multiple fractures in 2 patients and the missed diagnosis occurred in 1 patient. The preoperative diagnosis was accurate in 10 out of 11 patients with MRI examination. MRI cisternography is more advanced than multi-row CT scan in multiple basilar skull fracture. The combination of the two examinations may increase the diagnostic ratio of active cerebrospinal leak.
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影响因子：
2.4
作者：
Stanic K;Kovac V
通讯作者：
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影响因子：
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作者：
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