Cerebrospinal fluid rhinorrhea: evaluation with 3D-SPACE sequence and management with navigation-assisted endonasal endoscopic surgery

AbstractBackground: This study aimed to assess the efficacy of MR images with three-dimensional sampling perfection with application optimised contrast using different flip-angle evolution (3D-SPACE) sequence for detecting cerebrospinal fluid (CSF) rhinorrhea and image-guided surgery for the management of CSF rhinorrhea.Materials and methods: This study included 45 consecutive patients with suspected CSF rhinorrhea from 2010 to 2015. Patients underwent preoperative MRI scan including 3D-SPACE and conventional T2-weighted (T2W) protocol. Two-blinded neuroradiologists determined the presence and location of CSF leakage. Imaging results were compared with surgical findings and/or β-2 transferrin testing. Intraoperative navigation was used during endonasal endoscopic surgery for repairing CSF rhinorrhea.Results: 3D-SPACE sequence correctly described 27 cases (93.1%) and conventional T2W sequence described only 20 (69.0%) of the total 29 patients with truly positive CSF leakage. The sensitivity, specificity, p...