Mukesch Johannes Shah, Jürgen Beck, Stephan Meckel, Horst Urbach, Ikram Eda Duman, Manuel Christoph Ketterer, Tanja Hildenbrand
{"title":"高分辨率钆增强磁共振蝶窦成像和垫片密封技术治疗颅底前部缺损的可靠性。","authors":"Mukesch Johannes Shah, Jürgen Beck, Stephan Meckel, Horst Urbach, Ikram Eda Duman, Manuel Christoph Ketterer, Tanja Hildenbrand","doi":"10.1007/s00062-023-01339-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Precise preoperative localization of anterior skull base defects is important to plan surgical access, increase the success rate and reduce complications. A stable closure of the defect is vital to prevent recurrence of cerebrospinal fluid (CSF) rhinorrhea. The purpose of this retrospective case series was to evaluate the reliability of a new high-resolution gadolinium-enhanced compressed-sensing SPACE technique (CS T1 SPACE) for magnetic resonance (MR) cisternography to detect cerebrospinal fluid leaks of the anterior skull base and to assess the long-term success rate of the gasket-seal technique for closure of skull base defects.</p><p><strong>Method: </strong>All patients with spontaneous or postoperative cerebrospinal fluid rhinorrhea and defects of the anterior skull base presenting to the Departments of Otorhinolaryngology and Neurosurgery between 2019 and 2020, receiving a computed tomography (CT) cisternography and MR cisternography (on a 3T whole-body MR scanner using a 64-channel head and neck coil) with CS T1 SPACE sequence and closure of the defect with the gasket-seal technique, were enrolled in the study. For the cisternography, iodinated contrast agent (15 ml Solutrast 250 M®), saline (4 mL) mixed with a 0.5 mL of gadoteridol was injected into the lumbar subarachnoid space.</p><p><strong>Results: </strong>A total of four patients were included in the study and MR cisternography with CS T1 SPACE sequence was able to precisely localize CSF leaks in all patients. The imaging results correlated with intraoperative findings. All defects could be successfully closed with the gasket-seal technique. The mean follow-up was 35.25 months (range 33-37 months).</p><p><strong>Conclusion: </strong>MR cisternography with CS T1 SPACE sequence could be a promising technique for precise localization of CSF leaks and the gasket-seal technique resulted in good closure of the CSF fistula in this case series.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"115-123"},"PeriodicalIF":2.8000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881784/pdf/","citationCount":"0","resultStr":"{\"title\":\"Reliability of High-resolution Gadolinium-enhanced MR Cisternography and Gasket-seal Technique for Management of Anterior Skull Base Defects.\",\"authors\":\"Mukesch Johannes Shah, Jürgen Beck, Stephan Meckel, Horst Urbach, Ikram Eda Duman, Manuel Christoph Ketterer, Tanja Hildenbrand\",\"doi\":\"10.1007/s00062-023-01339-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Precise preoperative localization of anterior skull base defects is important to plan surgical access, increase the success rate and reduce complications. A stable closure of the defect is vital to prevent recurrence of cerebrospinal fluid (CSF) rhinorrhea. The purpose of this retrospective case series was to evaluate the reliability of a new high-resolution gadolinium-enhanced compressed-sensing SPACE technique (CS T1 SPACE) for magnetic resonance (MR) cisternography to detect cerebrospinal fluid leaks of the anterior skull base and to assess the long-term success rate of the gasket-seal technique for closure of skull base defects.</p><p><strong>Method: </strong>All patients with spontaneous or postoperative cerebrospinal fluid rhinorrhea and defects of the anterior skull base presenting to the Departments of Otorhinolaryngology and Neurosurgery between 2019 and 2020, receiving a computed tomography (CT) cisternography and MR cisternography (on a 3T whole-body MR scanner using a 64-channel head and neck coil) with CS T1 SPACE sequence and closure of the defect with the gasket-seal technique, were enrolled in the study. 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引用次数: 0
摘要
目的:术前对前颅底缺损进行精确定位对于规划手术入路、提高成功率和减少并发症非常重要。缺损的稳定闭合对防止脑脊液(CSF)鼻出血的复发至关重要。这项回顾性病例系列研究的目的是评估新型高分辨率钆增强压缩感应 SPACE 技术(CS T1 SPACE)用于磁共振(MR)颅底造影检测前颅底脑脊液漏的可靠性,并评估垫片密封技术用于闭合颅底缺损的长期成功率:所有在2019年至2020年期间到耳鼻咽喉科和神经外科就诊的自发性或术后脑脊液鼻漏和前颅底缺损患者均纳入研究,接受计算机断层扫描(CT)蝶形图和磁共振蝶形图(在3T全身磁共振扫描仪上使用64通道头颈线圈),并使用CS T1 SPACE序列和垫片密封技术闭合缺损。在进行蝶窦造影时,将碘化造影剂(15 毫升 Solutrast 250 M®)、生理盐水(4 毫升)与 0.5 毫升钆特醇混合后注入腰椎蛛网膜下腔:研究共纳入了四名患者,采用 CS T1 SPACE 序列的磁共振蝶窦造影能够精确定位所有患者的 CSF 漏点。成像结果与术中发现相关。所有缺损均可通过垫片密封技术成功闭合。平均随访时间为 35.25 个月(33-37 个月):结论:使用 CS T1 SPACE 序列进行磁共振蝶窦造影是一种很有前途的精确定位脑脊液漏的技术,在本病例系列中,垫片密封技术可成功闭合脑脊液瘘。
Reliability of High-resolution Gadolinium-enhanced MR Cisternography and Gasket-seal Technique for Management of Anterior Skull Base Defects.
Purpose: Precise preoperative localization of anterior skull base defects is important to plan surgical access, increase the success rate and reduce complications. A stable closure of the defect is vital to prevent recurrence of cerebrospinal fluid (CSF) rhinorrhea. The purpose of this retrospective case series was to evaluate the reliability of a new high-resolution gadolinium-enhanced compressed-sensing SPACE technique (CS T1 SPACE) for magnetic resonance (MR) cisternography to detect cerebrospinal fluid leaks of the anterior skull base and to assess the long-term success rate of the gasket-seal technique for closure of skull base defects.
Method: All patients with spontaneous or postoperative cerebrospinal fluid rhinorrhea and defects of the anterior skull base presenting to the Departments of Otorhinolaryngology and Neurosurgery between 2019 and 2020, receiving a computed tomography (CT) cisternography and MR cisternography (on a 3T whole-body MR scanner using a 64-channel head and neck coil) with CS T1 SPACE sequence and closure of the defect with the gasket-seal technique, were enrolled in the study. For the cisternography, iodinated contrast agent (15 ml Solutrast 250 M®), saline (4 mL) mixed with a 0.5 mL of gadoteridol was injected into the lumbar subarachnoid space.
Results: A total of four patients were included in the study and MR cisternography with CS T1 SPACE sequence was able to precisely localize CSF leaks in all patients. The imaging results correlated with intraoperative findings. All defects could be successfully closed with the gasket-seal technique. The mean follow-up was 35.25 months (range 33-37 months).
Conclusion: MR cisternography with CS T1 SPACE sequence could be a promising technique for precise localization of CSF leaks and the gasket-seal technique resulted in good closure of the CSF fistula in this case series.
期刊介绍:
Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects.
The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.