Computed Tomography Cisternography in the Evaluation of Traumatic CSF Rhinorrhea.

電腦斷層腦池攝影術對外傷性腦脊髓液鼻漏診斷之評估

黃榮貴(Jon-Kway Huang) ； 林清澤(Jackson CT Lin) ； 馬玉章(Yei-Chang Ma) ； 林烈生(Lieh-Sheng Lin) ； 祝利燦(Li-Then Juh) ； 陳忠信(William Wong Tan)

《中華放射線醫學雜誌》 18卷2期 (1993/06) Pp. 133-140

摘要

本文章主要在於評估使用非離子性水溶性顯影劑之電腦斷層腦池攝影術對偵測外傷性腦脊髓液鼻漏病變位置的價值。從1987年7月至1991年12月，回顧33例臨床上疑似外傷性腦脊髓液瘻管，其中有26位男性，7位女性，臨床表現的症狀為腦脊髓液鼻漏或腦膜炎。
在這33例中有20個病人接受電腦斷層腦池攝影術檢查，其中有兩位病人作兩次檢查，病人皆以俯臥位做軸狀切面及冠狀切面之影像，22次檢查中有14次檢查異常(64%)，有8次之電腦斷層腦池攝影無異常發現。近年來雖然磁振造影曾被應用於非外傷性腦脊髓液鼻漏之檢查，然而對於外傷性造成之鼻漏，電腦斷層腦池攝影術仍是一種最有價值的偵測方法。

關鍵字

腦脊髓液鼻漏 ； 腦部電腦斷層 ； 腦池攝影術

並列摘要

The purpose of this study is to evaluate the use of computed tomographic cisternography (CTC) with nonionic water soluble contrast medium in the detection of the site of leakage in patients with traumatic cerebrospinal fluid (CSF) rhinorrhea. From July 1987 to December 1991, 33 cases of clinically suspected post-traumatic CSF fistula were reviewed. There were 26 males and 7 females, presenting clinically as CSF rhinorrhea or meningitis.
A total of 22 CTC studies were performed in 20 cases in a prone position. Results were evaluated and considered positive according to one of the following three criteria: A) demonstration of contrast medium throught the bony defect , B) a bony defect with extracranial contrast medium adjacent to the bony defect, and C) visualization of contrast medium within one paranasal sinus or nasal cavity. Fourteen scans were positive (64%). They were criterion A in three scans, criterion B in six, criterion C in one, criteria A& B in two and criteria B&C in two. Criterion B was the most common. In eight scans, CTC examination was normal. The most common sites of CSF leak in decreasing frequency were the ethmoid sinus, the frontal sinus, the cribriform plate and the sphenoid sinus. Although the use of MRI has been reported in recent years, CT cisternography is still a valuable technique in the evaluation of patients with traumatic CSF rhinorrhea, not only delineating the contrast leakage, but also detecting the bony defect or the site of the fistula.

並列關鍵字

CSF, leakage ； cisternography, CT ； brain, CT