Payne Richard J, Frenkiel Saul, Glikstein Rafael, Mohr Gérard
Department of Otolaryngology, SMBD-Jewish General Hospital, McGill University, Montreal, PQ.
J Otolaryngol. 2003 Apr;32(2):93-100. doi: 10.2310/7070.2003.37260.
In a retrospective review of 13 patients, computed tomographic cisternography (CTC) was the primary imaging modality used for the detection of cerebrospinal fluid (CSF) leaks. In five of the cases, the diagnosis of CSF rhinorrhea was confirmed by the beta2-transferrin test. In the remaining cases, it was corroborated through endoscopic visualization, clinical history, and nuclear scanning. This study analyzes the efficacy of CTC in the detection of CSF leaks and discusses the different methods of computerized manipulation and reconstruction of the images for effective site localization. The study demonstrates that computerized reconstruction of images should be considered an integral part of CTC because it appears to be an inexpensive and simple diagnostic tool that improves on the accuracy of detection. Although T2-weighted magnetic resonance imaging may be helpful, this study emphasizes the efficacy of CTC in the diagnosis of CSF leaks. Using the techniques of image reconstruction improves on diagnostic precision with relatively little increase in cost, time, and labour. This study also introduces a diagnostic algorithm for otolaryngologists dealing with the challenge of identifying and locating CSF leaks.
在一项对13例患者的回顾性研究中，计算机断层脑池造影（CTC）是用于检测脑脊液（CSF）漏的主要成像方式。在其中5例病例中，脑脊液鼻漏的诊断通过β2-转铁蛋白检测得以证实。在其余病例中，则通过内镜观察、临床病史及核扫描得以佐证。本研究分析了CTC在检测脑脊液漏方面的有效性，并讨论了用于有效定位漏口的图像计算机处理及重建的不同方法。该研究表明，图像的计算机重建应被视为CTC不可或缺的一部分，因为它似乎是一种廉价且简单的诊断工具，能提高检测的准确性。尽管T2加权磁共振成像可能会有帮助，但本研究强调了CTC在脑脊液漏诊断中的有效性。使用图像重建技术可在成本、时间和人力增加相对较少的情况下提高诊断精度。本研究还为耳鼻喉科医生引入了一种诊断算法，以应对识别和定位脑脊液漏的挑战。
