Role of computed tomographic cisternography in the management of cerebrospinal fluid rhinorrhea.
In a retrospective review of 13 patients, computed tomographic cisternography (CTC) was the primary imaging modality used for the detection of cerebrospinal fluid (CSF) leaks. In five of the cases, the diagnosis of CSF rhinorrhea was confirmed by the beta2-transferrin test. In the remaining cases, it was corroborated through endoscopic visualization, clinical history, and nuclear scanning. This study analyzes the efficacy of CTC in the detection of CSF leaks and discusses the different methods of computerized manipulation and reconstruction of the images for effective site localization. The study demonstrates that computerized reconstruction of images should be considered an integral part of CTC because it appears to be an inexpensive and simple diagnostic tool that improves on the accuracy of detection. Although T2-weighted magnetic resonance imaging may be helpful, this study emphasizes the efficacy of CTC in the diagnosis of CSF leaks. Using the techniques of image reconstruction improves on diagnostic precision with relatively little increase in cost, time, and labour. This study also introduces a diagnostic algorithm for otolaryngologists dealing with the challenge of identifying and locating CSF leaks.
Payne
Richard J
RJ
Department of Otolaryngology, SMBD-Jewish General Hospital, McGill University, Montreal, PQ.
Frenkiel
Saul
S
Glikstein
Rafael
R
Mohr
Gérard
G
D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D002946:Cisterna Magna / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed