MR cisternography: a new method for the diagnosis of CSF fistulae

Eur Radiol. 1997;7(9):1485-91. doi: 10.1007/s003300050321.


The aim of this study was to compare a new MRI method for detecting the existence of cerebrospinal fluid (CSF) fistulae, i. e. MR cisternography, with CT cisternography. In a prospective study, 30 patients with post-traumatic CSF fistulae were examined. The MR examinations were performed with a 1.0-T whole-body MR system, using two T2(*)-weighted sequences, a 3D PSIF (time-inversed fast imaging with steady-state precession, FISP) and a 3D constructive interference steady-state (CISS) sequence. The results of MRI and CT cisternography were compared with the surgical findings. The sensitivity in detecting CSF fistulae with MR cisternography (PSIF: 89.9 %; CISS: 93.6 %) was higher than with CT cisternography (72.3 %). The sensitivity of CT cisternography at detecting CSF fistulae in patients with a size of dural lesion less than 2 mm or in patients with multiple dural lesions is significantly lower compared with the MR method. Although the localization of CSF fistulae always proved possible with MR cisternography, this could only be accomplished wih CT in 70 % of cases. The MR cisternography technique is a new examination method with a higher sensitivity for the detection of CSF fistulae than CT cisternography. The CISS technique is superior compared with PSIF and should be used in patients with high-flow CSF fistulas.

MeSH terms

  • Adolescent
  • Adult
  • Central Nervous System Diseases / diagnosis*
  • Central Nervous System Diseases / diagnostic imaging
  • Cerebrospinal Fluid Rhinorrhea / diagnosis
  • Cerebrospinal Fluid Rhinorrhea / diagnostic imaging
  • Cerebrospinal Fluid*
  • Dura Mater* / diagnostic imaging
  • Dura Mater* / injuries
  • Dura Mater* / pathology
  • Female
  • Fistula / diagnosis*
  • Fistula / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Subarachnoid Space / diagnostic imaging
  • Subarachnoid Space / pathology
  • Tomography, X-Ray Computed