[A case of spontaneous rhinorrhea detected by SPAMM-tagging method]

This is the first report of rhinorrhea detected by special modulation of the magnetization (SPAMM)-tagging method. A 54-year-old male was admitted to our hospital for treatment of right rhinorrhea which had continued for 2 months and a half. The CSF leakage was induced by specific head position and the volume was more than 50 ml a day. Metrizamide CT cisternography revealed the contrast medium in the lateral extension of the right sphenoid sinus. MRI demonstrated liquorrhea with abnormal intensity of the sinus. 3D-CT revealed bony defects at the temporal base. Operation revealed herniated brain through the same bony defect of the temporal base into the extended sphenoid sinus. Post-operative diagnosis was Morley's rhinorrhea. The leakage point was closed and patched with the femoral fascia. Preoperative SPAMM-tagging image with cine MRI was useful to identify the responsible leakage point as a disorder of lattice tags. This method is a kind of flowmetry with MRI and is very effective because it can detect non-invasively slight CSF motion into the sinuses. It can also detect the direction and rough flow volume of rhinorrhea, so may also predict the risk of meningitis. The disadvantages were also discussed.