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MR cisternography after intrathecal Gd-DTPA application.
Werner Reiche1, Yvonne Komenda, Bernhard Schick
1Department for Neuradiology, Radiologic Clinic, Centre for Skull Base Surgery, Saarland University Clinic, Homburg/Saar, Germany. reiche.k@t-online.de
European Radiology
|November 20, 2002
Summary
This study shows that Magnetic Resonance (MR) cisternography with intrathecal Gd-DTPA is a safe and effective method for detecting cerebrospinal fluid (CSF) fistulae. This technique accurately pinpoints CSF leaks in patients with suspected CSF rhinorrhoea.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Cerebrospinal fluid (CSF) rhinorrhoea presents a diagnostic challenge.
- Accurate detection of CSF fistulae is crucial for appropriate management.
Purpose of the Study:
- To establish and evaluate MR cisternography with intrathecal Gd-DTPA for detecting rhinobasal CSF fistulae.
- To assess the safety and efficacy of this diagnostic method.
Main Methods:
- Ten patients with suspected CSF rhinorrhoea underwent MR cisternography.
- This involved non-enhanced T1-weighted SE scans, lumbar puncture with intrathecal Gd-DTPA administration, and repeat MR cisternography.
Main Results:
- Gd-DTPA enhanced MR cisternography detected 5 CSF fistulae in 10 patients.
- Three leaks were in the cribriform plate, and two were in the sphenoid.
- Four leaks were surgically confirmed; one closed spontaneously. The method was well-tolerated with no adverse events.
Conclusions:
- MR cisternography after intrathecal Gd-DTPA is a safe, promising, and minimally invasive method for detecting CSF fistulae.
- The technique provides excellent visualization of CSF spaces and precise localization of fistulae.