磁共振3D-Cube T2序列成像对脑脊液鼻漏的诊断价值
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摘要
目的探讨磁共振3D-Cube T2序列成像在脑脊液鼻漏中的临床应用。方法回顾性分析2017年2月—2018年8月陆军军医大学第二附属医院收治的脑脊液鼻漏患者17例,其中10例为颅脑创伤,7例为垂体瘤术后。行MRI常规检查及3D-Cube T2序列成像,研究3D-Cube T2序列脑脊液鼻漏的表现,总结3D-Cube T2序列成像对脑脊液鼻漏诊断的优势。结果 17例患者发现脑脊液鼻漏14例,表现为鼻腔或鼻窦内与颅内脑脊液信号一致的高信号影,并可见沟通二者相连的线状高信号影。14例鼻漏患者一共发现漏口16个,分别位于右侧前组筛窦及上鼻道7个、额窦6个、蝶窦及鞍旁2个、筛板1个。结论磁共振3D-Cube T2序列为重T2加权水成像,脑脊液在此序列图像上表现为高信号,通过图像后处理能多角度展示脑脊液鼻漏漏口的确切位置。
Objective To explore the clinical application of magnetic resonance 3D-Cube T2 sequence in cerebrospinal fluid rhinorrhea( CSF rhinorrhea). Methods Seventeen patients with cerebrospinal fluid rhinorrhea in the Second Affiliated Hospital of Military Medical University from Feb. 2017 to Aug. 2018 were retrospectively analyzed. Ten of them were after traumatic brain surgery and seven were after pituitary adenoma surgery. Routine MRI examination and 3D-Cube T2 sequence imaging were performed to study the manifestation of CSF rhinorrhea in3D-Cube T2 sequence. The advantages of 3D-Cube T2 sequence imaging in the diagnosis of CSF rhinorrhea were summarized. Results CSF rhinorrhea was found in 14 of the 17 patients. The high signal intensity in the nasal cavity or sinuse was consistent with the intracranial CSF signal and the linear high signal shadows connecting the two areas could be observed. A total of 16 leaks were found in 14 cases,7 rhinorrheas were located in right anterior ethmoid sinus and superior nasal meatus,6 in frontal sinus,2 in sphenoid sinus and parasellar,and 1 in ethmoidal plate. Conclusion MR 3D-Cube T2 is a heavy T2 weighted water imaging sequence,and cerebrospinal fluid indicates high signal intensity. The exact location of CSF rhinorrhea can be demonstrated after image postprocessing.
Objective To explore the clinical application of magnetic resonance 3D-Cube T2 sequence in cerebrospinal fluid rhinorrhea( CSF rhinorrhea). Methods Seventeen patients with cerebrospinal fluid rhinorrhea in the Second Affiliated Hospital of Military Medical University from Feb. 2017 to Aug. 2018 were retrospectively analyzed. Ten of them were after traumatic brain surgery and seven were after pituitary adenoma surgery. Routine MRI examination and 3D-Cube T2 sequence imaging were performed to study the manifestation of CSF rhinorrhea in3D-Cube T2 sequence. The advantages of 3D-Cube T2 sequence imaging in the diagnosis of CSF rhinorrhea were summarized. Results CSF rhinorrhea was found in 14 of the 17 patients. The high signal intensity in the nasal cavity or sinuse was consistent with the intracranial CSF signal and the linear high signal shadows connecting the two areas could be observed. A total of 16 leaks were found in 14 cases,7 rhinorrheas were located in right anterior ethmoid sinus and superior nasal meatus,6 in frontal sinus,2 in sphenoid sinus and parasellar,and 1 in ethmoidal plate. Conclusion MR 3D-Cube T2 is a heavy T2 weighted water imaging sequence,and cerebrospinal fluid indicates high signal intensity. The exact location of CSF rhinorrhea can be demonstrated after image postprocessing.
引文
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[9]樊子健,吴丽萍,任有忠,等. 3. 0T磁共振T2-Mapping、3D-FSE-Cube与常规序列对新关节软骨损伤分级对比分析[J].磁共振成像,2017,8(9):675-680.
[10]周进,刘四斌,胡玖益,等. 3D-Cube PD序列在膝关节外伤中的应用价值[J].长江大学学报(自科版),2017,14(12):41-43.
[11]孟祥红,王植,杨建平,等.应用T2 mapping及CUBE序列观察盘状软骨对发育性髋关节发育不良关节软骨的影响[J].国际医学放射学杂志,2018,41(4):396-400.
[2] Jayakumar PN,Kovoor JM,Srikanth SG,et al. 3D steadystate MR cisternography in CSF rhinorrhea[J]. J Acta Radiol,2001,42(6):582-584.
[3]武天奎. MRI水成像技术诊断脑脊液鼻漏中的价值[J].中国实用医刊,2010,37(6):34-36.
[4] Lopatin AS,Kapitannov DN,Potapov AA. Endonasal endoscopic repair of spontaneous cerebrospinal fluid leaks[J].Arch Otolaryngol Head Neck Surgy,2003,129(8):859-863.
[5]张艳阳,陈晓雷,孟祥辉,等. 3D-SPACE序列在脑脊液鼻瘘诊断及导航辅助鼻内镜修补术的应用[J].中枢神经影像学,2016,24(2):96-99.
[6]季玉陈,延鹏翔,李岩,等.自发性脑脊液鼻漏12例诊断与治疗[J].广东医学,2015,36(4):588-590.
[7]徐华,郑燕,张琰,等.多层螺旋CT脑池造影诊断脑脊液鼻漏的价值[J].医学影像学杂志,2013,23(7):1001-1003,1007.
[8] Ecin G,Oner AY,Tokgoz N,et al. T2-weighted vs. intrathecal contrast-enhanced MR cisternography in the evaluation of CSF rhinorrhea[J]. Acta Radiol,2013,54(6):698-701.
[9]樊子健,吴丽萍,任有忠,等. 3. 0T磁共振T2-Mapping、3D-FSE-Cube与常规序列对新关节软骨损伤分级对比分析[J].磁共振成像,2017,8(9):675-680.
[10]周进,刘四斌,胡玖益,等. 3D-Cube PD序列在膝关节外伤中的应用价值[J].长江大学学报(自科版),2017,14(12):41-43.
[11]孟祥红,王植,杨建平,等.应用T2 mapping及CUBE序列观察盘状软骨对发育性髋关节发育不良关节软骨的影响[J].国际医学放射学杂志,2018,41(4):396-400.