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3D-Cube T2序列联合颅底CT平扫对脑脊液鼻漏的诊断价值
Diagnostic value of 3D-Cube T2 sequence combined with plain CT scan of the skull base for cerebrospinal fluid rhinorrhea
- 第三军医大学学报 2019年41卷第10期 页码：969-973
- 作者机构：
400037 重庆，陆军军医大学(第三军医大学)第二附属医院放射科
- 作者简介：
[ 邹利光，E-mail: zlgxqyy@163.com ZOU Liguang, E-mail: zlgxqyy@163.com
- 基金信息：国家自然科学基金青年科学基金(81401466)
DOI：10.16016/j.1000-5404.201811125
中图分类号： R651.1;R814.42;R816.1收稿：2018-11-07，
修回：2018-12-12，
纸质出版：2019-05-30
- 稿件说明：
移动端阅览
甘慧, 张松, 姜利伶, 等. 3D-Cube T2序列联合颅底CT平扫对脑脊液鼻漏的诊断价值[J]. 第三军医大学学报, 2019,41(10):969-973.
Hui GAN, Song ZHANG, Liling JIANG, et al. Diagnostic value of 3D-Cube T2 sequence combined with plain CT scan of the skull base for cerebrospinal fluid rhinorrhea[J]. Journal of Third Military Medical University, 2019, 41(10): 969-973.
甘慧, 张松, 姜利伶, 等. 3D-Cube T2序列联合颅底CT平扫对脑脊液鼻漏的诊断价值[J]. 第三军医大学学报, 2019,41(10):969-973. DOI： 10.16016/j.1000-5404.201811125.
Hui GAN, Song ZHANG, Liling JIANG, et al. Diagnostic value of 3D-Cube T2 sequence combined with plain CT scan of the skull base for cerebrospinal fluid rhinorrhea[J]. Journal of Third Military Medical University, 2019, 41(10): 969-973. DOI： 10.16016/j.1000-5404.201811125.
摘要
目的
2
评价磁共振3D-Cube T2序列、颅底CT平扫及两者联合对脑脊液鼻漏的诊断价值
探讨二者联用对提高脑脊液鼻漏检出率及漏口定位的作用。
方法
2
回顾性分析2016年2月至2018年10月本院经手术或临床证实的22例脑脊液鼻漏患者的影像学资料，22例均行常规头颅磁共振MRI平扫及矢状面或冠状面3D-Cube T2序列检查，其中13例还进行了颅底CT平扫检查，研究二者结合对脑脊液鼻漏的检出率。
结果
2
22例脑脊液鼻漏患者中，3D-Cube T2序列诊断17例(17/22，检出率77.3%)，颅底CT平扫诊断9例(9/13，检出率69.2%)。13例联合3D-Cube T2序列检查及颅底CT平扫的病例中，脑脊液鼻漏共检出12例(12/13，检出率92.3%)。3D-Cube T2序列结合颅底CT平扫共发现21个可疑漏口，分别位于筛窦顶壁及上鼻道10个、额窦7个、蝶窦及鞍旁2个、筛板2个。
结论
2
磁共振3D-Cube T2序列可通过后处理多平面重组清晰显示脑脊液鼻漏漏口的准确位置，颅底CT平扫可观察鼻窦或鼻腔局部骨质连续性中断、分离或者脑组织疝入骨缺损处的情况，两者结合能提高脑脊液鼻漏检出率。
Abstract
Objective
2
To evaluate the diagnostic value of magnetic resonance 3D-Cube T2 sequence
plain CT scan of the skull base and their combination for cerebrospinal fluid (CSF) rhinorrhea and assess the performance of these 2 modalities combined in improving the detection rate of CSF rhinorrhea and in localization of CSF leakage.
Methods
2
We retrospectively analyzed the imaging data of 22 patients with CSF rhinorrhea confirmed surgically or clinically in our hospital from February
2016 to October
2018. All the patients underwent routine cranial magnetic resonance imaging (MR) plain scan and 3D-Cube T2 sequence on the sagittal or coronal plane; 13 of the patients also underwent plain CT scan of the skull base
and the detection rate of CSF rhinorrhea by combining the two modalities was assessed.
Results
2
Of the 22 patients with CSF rhinorrhea
17 (77.3%) were diagnosed based on findings by 3D-Cube T2 sequence; the diagnosis was established in 9 (69.2%) out of the 13 patients undergoing plain CT scan of the skull base. In the 13 cases having both 3D-Cube T2 sequence examination and plain CT scan of the skull base
the detection rate of CSF rhinorrhea was 92.3% (12/13). A total of 21 suspicious leaks were found by 3D-Cube T2 sequence combined with plain CT scan
including 9 in the upper wall of the ethmoid sinus and the superior nasal meatus
11 in the frontal sinus
3 in the sphenoid sinus and the parasellar region
and 2 in the ethmoid plate.
Conclusion
2
MR 3D-Cube T2 sequence can show the precise location of CSF leak through post-processing multi-plane reconstruction. Plain CT scan of the skull base allows observation of the interruption of bone tissue continuity
separation in the sinus or nasal cavity
and brain tissue herniation into the bone defect. The combination of these 2 modalities can improve the detection rate of CSF rhinorrhea.
关键词
Keywords
references
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