Non-invasive Radiologic Evaluation of Intermittent CSF Rhinorrhea

Non-invasive Radiologic Evaluation of Intermittent CSF Rhinorrhea

Background: Cerebrospinal fluid (CSF) fistulae that present as intermittent rhinorrhea can be a diagnostic challenge. Many imaging modalities are currently used for detection of a CSF fistula, including invasive techniques such as CT Cisternography and Radionuclide Cisternography. The purpose of this study is to present our experience with non-invasive imaging of intermittent CSF rhinorrhea.

Methods: Retrospective chart review of New York University Medical Center patient database with suspected intermittent CSF rhinorrhea.

Results: Nine patients were included in this study; a β2-transferrin assay was performed when possible. All patients had imaging that included High-Resolution CT (HRCT), MR Cisternography (MRC), or a combination of the two. When HRCT was combined with MRC the sensitivity and accuracy of detecting and localizing a CSF fistula were both 100%.

Conclusion: Intermittent CSF rhinorrhea may be evaluated with HRCT and MR Cisternography, as these two modalities have good reliability and are non-invasive techniques.