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Wang X, Xu M, Liang H, et al. Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base. Radiol Oncol. 2011;45(2):91-6doi: 10.2478/v10019-011-0007-6.
Wang, X., Xu, M., Liang, H., & Xu, L. (2011). Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base. Radiology and oncology, 45(2), 91-6. https://doi.org/10.2478/v10019-011-0007-6
Wang, Xuhui, et al. "Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base." Radiology and oncology vol. 45,2 (2011): 91-6. doi: https://doi.org/10.2478/v10019-011-0007-6
Wang X, Xu M, Liang H, Xu L. Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base. Radiol Oncol. 2011 Jun;45(2):91-6. doi: 10.2478/v10019-011-0007-6. Epub 2011 Mar 15. PMID: 22933941; PMCID: PMC3423734.
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Radiol Oncol. 2011 Jun;45(2):91-6. doi: 10.2478/v10019-011-0007-6. Epub 2011 Mar 15.

Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base.

Radiology and oncology

Xuhui Wang, Minhui Xu, Hong Liang, Lunshan Xu

Affiliations

  1. Department of Neurosurgery, Research Institute of Surgery & Daping Hospital, Third Military Medical University, Chongqing, China.

PMID: 22933941 PMCID: PMC3423734 DOI: 10.2478/v10019-011-0007-6

Abstract

BACKGROUND: Multiple basilar skull fracture and cerebrospinal leak are common complications of traumatic brain injury, which required a surgical repair. But due to the complexity of basilar skull fracture after severe trauma, preoperatively an exact radiological location is always difficult. Multi-row spiral CT and MRI are currently widely applied in the clinical diagnosis. The present study was performed to compare the accuracy of cisternography by multi-row spiral CT and MRI in the diagnosis of cerebrospinal leak.

METHODS: A total of 23 patients with multiple basilar skull fracture after traumatic brain injury were included. The radiological and surgical data were retrospectively analyzed. 64-row CT (mm/row) scan and three-dimensional reconstruction were performed in 12 patients, while MR plain scan and cisternography were performed in another 11 patients. The location of cerebrospinal leak was diagnosed by 2 experienced physicians majoring neurological radiology. Surgery was performed in all patients. The cerebrospinal leak location was confirmed and repaired during surgery. The result was considered as accurate when cerebrospinal leak was absent after surgery.

RESULTS: According to the surgical exploration, the preoperative diagnosis of the active cerebrospinal leak location was accurate in 9 out of 12 patients with CT scan. The location could not be confirmed by CT because of multiple fractures in 2 patients and the missed diagnosis occurred in 1 patient. The preoperative diagnosis was accurate in 10 out of 11 patients with MRI examination.

CONCLUSIONS: MRI cisternography is more advanced than multi-row CT scan in multiple basilar skull fracture. The combination of the two examinations may increase the diagnostic ratio of active cerebrospinal leak.

Keywords: CT; MRI; cerebrospinal leak; diagnosis; multiple basilar skull fracture

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