MR evaluation of CSF fistulae.
OBJECTIVE
To evaluate the role of MR imaging in the localisation of cerebrospinal fluid (CSF) fistulae.


METHODS
A total of 36 consecutive unselected patients with either clinically proven CSF leakage (n=26) or suspected CSF fistula (n=10) were prospectively evaluated by MR. All MR examinations included fast spin-echo T2-weighted images in the 3 orthogonal planes. Thin-section CT was performed following equivocal or negative MR examination. MR and CT findings were correlated with surgical results in 33 patients.


RESULTS
CSF fistula was visualised as a dural-bone defect with hyperintense fluid signal continuous with that in the basal cisterns on T2-weighted images. MR was positive in 26 cases, in 24 of which the fistula was confirmed surgically. In 2 patients the CSF leakage was directly demonstrated on MR. MR sensitivity of 80% compared favourably with the reported 46-81% of CT cisternography (CTC). No significant difference in MR sensitivity in detecting CSF fistula was found between active and inactive leaks


CONCLUSIONS
MR is recommended as the first investigation for detecting a CSF fistula owing to its efficacy and to its freedom from the potential complications encountered with CTC.
Gupta
V
V
Department of Neuroradiology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi.
Goyal
M
M
Mishra
N
N
Gaikwad
S
S
Sharma
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002558:Cerebrospinal Fluid Otorrhea / Q000175:diagnosis*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed