Wilson Andrew, Walter Carissa, Clark Lauren, Shi Peng, Guenther Mitchell
Kansas City University College of Osteopathic Medicine, Kansas City, MO.
Department of Radiology, University of Kansas Medical Center, Kansas City, KS.
Kans J Med. 2022 Jun 20;15(2):205-207. doi: 10.17161/kjm.vol15.16299. eCollection 2022.
Cerebrospinal fluid (CSF) leaks occur when fluid seeps through a dural or skull base defect, typically in the nose or ear. CSF leaks commonly are identified and diagnosed by use of computed tomography (CT) and CT cisternogram. CT findings suggestive of a CSF leak include a skull-based bone defect along with opacification of the contiguous sinus. This study examined a series of CSF leaks on CT imaging to document imaging findings.
A single-institution retrospective review of cases of CSF leak diagnosed by CT maxillofacial or CT cisternogram from January 1, 2008 to March 12, 2018 was performed. Patient demographics, history, imaging findings, and treatment were recorded.
Thirty-nine patients met the inclusion criteria for the study. The average age was 51, and a large majority were female (76.9%). Among the 25 patients in which it was reported, the mean size of skull base defect was 0.472 cm. Of the 39 total cases, 27 patients (69.2%) presented with sinus opacification on CT imaging.
Radiologists should be aware of the possibility of notable sinus opacification observable on CT when investigating a potential CSF leak. Opacification may vary in both location and size depending on the nature and location of a CSF leak. Further research is needed to draw a correlation between sinus opacification seen on CT scan and the diagnosed origin of a CSF leak.
脑脊液（CSF）漏是指脑脊液通过硬脑膜或颅底缺损处渗出，通常发生在鼻腔或耳部。脑脊液漏通常通过计算机断层扫描（CT）和CT脑池造影来识别和诊断。CT上提示脑脊液漏的表现包括颅底骨质缺损以及相邻鼻窦的混浊。本研究通过CT成像检查了一系列脑脊液漏病例，以记录影像学表现。
对2008年1月1日至2018年3月12日期间经CT颌面或CT脑池造影诊断为脑脊液漏的病例进行单机构回顾性研究。记录患者的人口统计学信息、病史、影像学表现和治疗情况。
39例患者符合研究纳入标准。平均年龄为51岁，大多数为女性（76.9%）。在报告的25例患者中，颅底缺损的平均大小为0.472厘米。在39例病例中，27例（69.2%）在CT成像上表现为鼻窦混浊。
放射科医生在检查潜在的脑脊液漏时应意识到CT上可能出现明显的鼻窦混浊。混浊的位置和大小可能因脑脊液漏的性质和位置而异。需要进一步研究以确定CT扫描上所见的鼻窦混浊与脑脊液漏诊断来源之间的相关性。
