多层螺旋CT脑池造影对外伤性脑脊液鼻漏的临床价值

Value of multi-slice spiral CT cisternography in diagnosis of the traumatic CSF rhinorrhea

目的探讨多层螺旋CT脑池造影(MSCTC)对外伤性脑脊液鼻漏的诊断价值。方法对6例临床诊断外伤性脑脊液鼻漏患者术前进行多层螺旋CT脑池造影检查,采用多平面重建(MPR)、最大密度投影(MIP)、容积再现(VR)技术,选择适当的显示层厚及角度,明确漏口存在,观察漏口的大小、形态及周围结构情况,并与术中所见对照,分析多层螺旋CT脑池造影对外伤性脑脊液鼻漏漏口定位及漏口周围情况评估的准确性,指导临床医师术前准备。结果全部病例检查后发现漏口存在,漏口大小、形态与术中所见基本吻合。结论多层螺旋CT脑池造影及后处理重组技术可以从不同角度较直观的反映漏口的位置、形态及漏口的周围情况,为临床手术治疗脑脊液鼻漏具有重要的指导价值,是术前首选的检查方法。

Objective To disseuss value of multi slice spiral CT cisternography in diagnosis of the traumatic cerebrospihal fluid （CSF） rhinorrhea. Methods 6 cases with CSF rihnorrhea were implemented by multi-slice spiral CT eisternography who were confirmed by physical examination before surgical operation. The following reconstruction techniques after scaning were adopted, such as multiple planar reconstruction （MPR）, maximum intensity projection （MIP）, and volume rendering （VR）. We selected proper slice thickness and angle during the reconstruction process to detect distinctly whether or not the sites of CSF leakage existed, and size, shape as well as relationship between peripheral stucture and itself, later, compared with what had been seen in surgical operation. Through the above-mentioned methods, we can analyze accuracy for localization of the sites of CSF leakage and evaluating surrounding situation so as to give surgeons more information for better preparation of operation. Results What we had detected by multi-slice spiral CT cisternography were ap proximately similar to what we had watched in surgical operation. Conclusion Distinct location, shape and peripheral structure of the sites of CSF leakage can be relatively comprehensively revealed through multi-slice spiral CT clsternogra phy and post-processing reconstraction techniques, there are significant direction value to treat patients who suffered from SCF rhinorrhea. As a result, we consider that multi-slice spiral CT cisternography is a best way of detecting CSF rhinor rhea at present before surgical operation.