MR cisternography after intrathecal Gd-DTPA application

被引：0

作者：

Werner Reiche

Yvonne Komenda

Bernhard Schick

Iris Grunwald

Wolf-Ingo Steudel

Wolfgang Reith

机构：

[1] Department for Neuroradiology,

[2] Radiological Clinic,undefined

[3] Centre for Skull Base Surgery,undefined

[4] Saarland University Clinic,undefined

[5] Homburg/Saar,undefined

[6] Germany,undefined

[7] Clinic for Neurosurgery,undefined

[8] Centre for Skull Base Surgery,undefined

[9] Saarland University Clinic,undefined

[10] Homburg/Saar,undefined

[11] Germany,undefined

[12] Clinic for Ear,undefined

[13] Nose and Throat,undefined

[14] Centre for Skull Base Surgery,undefined

[15] Saarland University Clinic,undefined

[16] Homburg/Saar,undefined

[17] Germany,undefined

[18] Institute for Radiology,undefined

[19] Klinikum Lahr,undefined

[20] Postfach 1727,undefined

[21] 77931 Lahr,undefined

[22] Germany,undefined

来源：

European Radiology | 2002年 / 12卷

关键词：

Cerebrospinal fluid fistula Intrathecal contrast media administration Cisternography Gadolinium DTPA Magnetic resonance imaging;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

The purpose of this study was to establish and to evaluate MR cisternography after intrathecal Gd-DTPA administration to detect rhinobasal cerebrospinal fluid (CSF) fistulae in patients with suspected CSF rhinorrhoea. Ten patients with suspected CSF rhinorrhoea were examined. The MR cisternography included the following investigation steps: acquisition of nonenhanced fat-suppressed T1-weighted spin-echo (SE) scans of the skull base and the paranasal sinuses, lumbar puncture with administration of 1 ml Gd-DTPA solute with 4 ml NaCl and performance of MR cisternography with the same fat-suppressed T1-weighted sequences as used initially. In 10 patients with suspected CSF rhinorrhoea Gd-DTPA enhanced MR cisternography detected 5 CSF fistulae. In 3 of 5 CSF leaks were located in the cribriform plate and in 2 of 5 sphenoidal. Whereas 4 of these depicted leaks were confirmed surgically, in 1 case the CSF fistula closed spontaneously. In another case, CSF leakage after severe head injury was clinically highly suspected but ceased prior to MR cisternography with inability to detect the temporary fistula. In the remaining 4 patients with serous rhinorrhoea MR cisternography did not provide any evidences for CSF fistulae. Intrathecal Gd-DTPA injection was tolerated excellently. Clinical and EEG examinations showed no gross behavioural or neurological disturbances and no seizure activity, respectively. The MR cisternography after intrathecal administration of Gd-DTPA represents a safe, promising and minimally invasive method for detection of CSF fistulae. This MR investigation provides excellent depiction of CSF spaces and pinpoints CSF fistulae.

引用

页码：2943 / 2949

页数：6