3D-Cube T2序列联合颅底CT平扫对脑脊液鼻漏的诊断价值

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英文篇名：Diagnostic value of 3D-Cube T2 sequence combined with plain CT scan of the skull base for cerebrospinal fluid rhinorrhea 作者：甘慧 ; 张松 ; 姜利伶 ; 葛晓东 ; 邹利光 英文作者：GAN Hui;ZHANG Song;JIANG Liling;GE Xiaodong;ZOU Liguang;Department of Radiology,Second Affiliated Hospital,Army Medical University(Third Military Medical University); 关键词：磁共振成像 ; 3D-Cube ; T2序列 ; 体层摄影技术 ; 颅底CT平扫 ; 脑脊液鼻漏 英文关键词：magnetic resonance imaging;;3D-Cube T2 sequence;;tomography,X-ray computed;;plain CT scan of the skull base;;cerebrospinal fluid rhinorrhea 中文刊名：DSDX 英文刊名：Journal of Third Military Medical University 机构：陆军军医大学(第三军医大学)第二附属医院放射科; 出版日期：2019-01-09 09:58 出版单位：第三军医大学学报 年：2019 期：v.41;No.561 基金：国家自然科学基金青年科学基金(81401466)~~ 语种：中文; 页：DSDX201910011 页数：5 CN：10 ISSN：50-1126/R 分类号：69-73

摘要

目的评价磁共振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 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。
        Objective To evaluate the diagnostic value of magnetic resonance 3 D-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 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 3 D-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 Of the 22 patients with CSF rhinorrhea, 17(77.3%) were diagnosed based on findings by 3 D-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 3 D-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 3 D-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 MR 3 D-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.

引文

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