Fluoroscopy-guided multiphase flat panel CT cisternography to diagnose complex skull base CSF leaks.

Area of Science:

• Neurosurgery
• Radiology
• Medical Imaging

Background:

• Skull base cerebrospinal fluid (CSF) leaks present diagnostic challenges.
• Accurate localization of the leak's origin, pathway, and termination is crucial for effective treatment.

Purpose of the Study:

• To report a novel fluoroscopy-guided multiphase flat panel computed tomography (CT) cisternography technique.
• To evaluate its feasibility and technical details for diagnosing CSF leaks in complex postoperative settings.

Main Methods:

• A fluoroscopy-guided multiphase flat panel CT cisternography was performed.
• The technique allowed detailed visualization of the CSF leak's entry point, pathway, and exit point.

Main Results:

• The described technique successfully visualized a CSF leak in a complex postoperative anterior cranial fossa.
• Detailed anatomical information regarding the leak was obtained.

Conclusions:

• Fluoroscopy-guided multiphase flat panel CT cisternography is a feasible and valuable addition to the diagnostic workup of complex CSF leaks.
• This technique is applicable to both anterior and middle cranial fossa CSF leaks.