关键词: 颅脑外伤, 脑脊液鼻漏, 脑脊液水成像, 脑池造影

Abstract: Objective This paper aims to investigate the application of MR HT2-FSE sequence hydrography combined with CT cisternography in craniotomy for traumatic cerebrospinal fluid rhinorrhea.Methods A total of 31 patients with traumatic cerebrospinal fluid rhinorrhea admitted to the First Affiliated Hospital of Anhui Medical University in the past 3 years from October 2018 to October 2020 was selected as the research subject.Preoperative magnetic resonance HT2-FSE sequence hydrography and CT Cisternography were completed before the surgery.We set the position of intraoperative visual leakage as the gold standard.The diagnostic value of different preoperative imaging localization methods for cerebrospinal fluid rhinorrhea was compared,and the recurrence and complications of craniotomy for cerebrospinal rhinorrhea were observed at the same time.Results 35 leakages were found by preoperativeMR HT2-FSE sequence hydrography combined with CT cisternography on 31 patients with traumatic cerebrospinal fluid rhinorrhea,34 among which were consistent with intraoperative direct vision (97%).The sensitivity,specificity,Kappa value and Youden index of MR HT2-FSE sequence hydrography sequence were 86%,80%,0.49 and 0.66 respectively.In addition,CT cisternography showed 91% sensitivity,45% specificity,0.41 Kappa value,0.37 Youden index,while the sensitivity,specificity,Kappa value and Youden index of MR HT2-FSE sequence hydrography combined with CT cisternography were 97%,89%,0.86 and 0.86 respectively.MR HT2-FSE sequence hydrographycombined with CT cisternography had higher consistency with intraoperative direct vision.There was no significant difference between the three imaging localization methods in the localization of cerebrospinal fluid rhinorrhea and intraoperative direct vision (P＞0.05),and the sensitivity and specificity of combined examination were better than that of single examination.All patients were successfully repaired once,and no recurrent rhinorrhea was observed.Conclusion Magnetic resonance HT2-FSE sequence hydrography combined with CT cisternography can accurately locate the leak location of traumatic cerebrospinal fluid rhinorrhea,providing a basis for accurate intra-operative repair of the leakage.

Key words: Craniocerebral injury, Cerebrospinal fluid leakage, Cerebrospinal fluid water imaging, Cisternography