Frick M, Rösler H, Escher F
HNO. 1977 Feb;25(2):67-71.
The radioisotope cisternogram has proven itself to be a valuable diagnostic procedure during the evaluation of patients with cerebrospinal fluid (CSF) rhinorrhea. If it is not possible to define the origin of such a leak, extensive intracranial explorations may be required, which may or may not result in successful correction of the defect. As a functional examination with limited risk to the patient and minimal radiation exposure, the isotopic cisternogram can either establish a diagnosis of CSF rhinorrhea or eliminate cerebrospinal fluid as a cause for rhinorrhea. When occurring, CSF leaks can be shown by demonstrating a "path" from the cranial fossage into the nasal cavity. The present technique utilizes tampons placed in each nostril. A positive diagnosis of CSF rhinorrhea is made by finding a tampon impregnated with at least twice the radioactivity of a control tampon from the opposite nostril (in the presence of an intact septum). Conclusions indicate that a positive anterior fossa cisternogram may be the only evidence for hidden site of CSF leakage, especially when other signs are lacking.
放射性核素脑池造影已证明自身在评估脑脊液鼻漏患者时是一种有价值的诊断方法。如果无法确定这种漏液的来源,可能需要进行广泛的颅内探查,而这可能成功也可能无法成功修复缺损。作为一种对患者风险有限且辐射暴露最小的功能检查,同位素脑池造影既可以确诊脑脊液鼻漏,也可以排除脑脊液是鼻漏的病因。脑脊液漏发生时,可通过显示从颅窝到鼻腔的“路径”来表明。目前的技术是在每个鼻孔放置棉球。脑脊液鼻漏的阳性诊断是通过发现一个棉球的放射性至少是来自对侧鼻孔的对照棉球(在鼻中隔完整的情况下)放射性的两倍来做出的。结论表明,前颅窝脑池造影呈阳性可能是脑脊液漏隐匿部位的唯一证据,尤其是在缺乏其他体征时。