Intrathecal Gadolinium-Enhanced MR Cisternography in the Evaluation of CSF Leakage
Intrathecal Gadolinium-Enhanced MR Cisternography in the Evaluation of CSF Leakage
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DOI：
10.3174/ajnr.a1788
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发表时间：
2010-01-01
影响因子：
3.5
通讯作者：
Islak, C.
中科院分区：
文献类型：
--
作者：
Selcuk, H.;Albayram, S.;Islak, C.
背景和目的：对脑脊液漏部位的放射学鉴定对于正确的手术计划和增加硬脑膜修补的机会是重要的。本文描述了我们应用磁共振成像结合鞘内注射Gd造影剂分析临床疑似脑脊液漏的经验。材料与方法：2003年至2007年，连续85例疑似脑脊液漏的患者出现持续性或间歇性鼻漏或耳漏超过1个月。结果：我们观察了85例(75%)的脑脊液客观渗漏。脑脊液漏位于筛区37例(58%)，蝶窦上壁8例(13%)，额窦后壁10例(15%)，乳突气房上壁6例(9%)，从颅底进入颞下窝1例(2%)。2例(3%)患者出现鼻窦渗漏。结论：鞘内注射加多喷丁胺后行MR脑池造影术是一种有效且微创的方法，可用于评估可疑的颅底脑脊液瘘。它提供了无辐射暴露风险的多平面能力，是描述脑脊液间隙和脑脊液瘘解剖的极佳方法，
BACKROUND AND PURPOSE: Radiologic identification of the location of the CSF leakage is important for proper surgical planning and increases the chance of dural repair. This article describes our experience in analyzing clinically suspected cranial CSF fistulas by using MR imaging combined with the intrathecal administration of a gadolinium-based contrast agent.MATERIALS AND METHODS: A total of 85 consecutive patients with suspected CSF fistulas who presented with persistent or intermittent rhinorrhea or otorrhea lasting for more than 1 month between 2003 and 2007 were included in this study.RESULTS: We observed objective CSF leakage in 64 of 85 patients (75%). The CSF leak was located in the ethmoidal region in 37 patients (58%), in the superior wall of the sphenoid sinus in 8 patients (13%), in the posterior wall of the frontal sinus in 10 patients (15%), in the superior wall of the mastoid air cells in 6 patients (9%), and from the skull base into the infratemporal fossa in I patient (2%). Two patients (3%) showed leakage into >1 paranasal sinus.CONCLUSIONS: MR cisternography after the intrathecal administration of gadopentate dimeglumine represents an effective and minimally invasive method for evaluating suspected CSF fistulas along the skull base. It provides multiplanar capabilities without risk of radiation exposure and is an excellent approach to depict the anatomy of CSF spaces and CSF fistulas,