Skip to main content
Top
Published in: Nuclear Medicine and Molecular Imaging 2/2017

01-06-2017 | Interesting image

Visual and Quantitative Analysis of Cisternography for the Detection of Cerebrospinal Fluid Leakage

Authors: Eun Kyoung Choi, Jin Kyoung Oh, Sonya Youngju Park, Ikdong Yoo, Dong-Hyun Kim, Yong-An Chung

Published in: Nuclear Medicine and Molecular Imaging | Issue 2/2017

Login to get access

Abstract

We herein present a case of a 29-year-old man with clear rhinorrhea, which persisted for 8 years following a myringotomy. After cotton pledgets were placed in several different regions of the nasal cavity, cisternography using Tc-99m DTPA was performed to measure the radioactivity of each pledget. Cisternography showed subtle uptake in the nasal cavity. However, intense uptake was detected in the pledget placed in the right eustachian tube orifice, where the pledget:serum count ratio was 10.3:1. The patient underwent duroplasty and cranioplasty, and the rhinorrhea resolved.
Literature
1.
go back to reference Prosser JD, Vender JR, Solares CA. Traumatic cerebrospinal fluid leaks. Otolaryngol Clin N Am. 2011;44:857–73. vii.CrossRef Prosser JD, Vender JR, Solares CA. Traumatic cerebrospinal fluid leaks. Otolaryngol Clin N Am. 2011;44:857–73. vii.CrossRef
2.
go back to reference Kerr JT, Chu FW, Bayles SW. Cerebrospinal fluid rhinorrhea: diagnosis and management. Otolaryngol Clin N Am. 2005;38:597–611.CrossRef Kerr JT, Chu FW, Bayles SW. Cerebrospinal fluid rhinorrhea: diagnosis and management. Otolaryngol Clin N Am. 2005;38:597–611.CrossRef
3.
go back to reference Bell RB, Dierks EJ, Homer L, Potter BE. Management of cerebrospinal fluid leak associated with craniomaxillofacial trauma. J Oral Maxillofac Surg. 2004;62:676–84.CrossRefPubMed Bell RB, Dierks EJ, Homer L, Potter BE. Management of cerebrospinal fluid leak associated with craniomaxillofacial trauma. J Oral Maxillofac Surg. 2004;62:676–84.CrossRefPubMed
4.
go back to reference Morioka T, Aoki T, Tomoda Y, Takahashi H, Kakeda S, Takeshita I, et al. Cerebrospinal fluid leakage in intracranial hypotension syndrome: usefulness of indirect findings in radionuclide cisternography for detection and treatment monitoring. Clin Nucl Med. 2008;33:181–5.CrossRefPubMed Morioka T, Aoki T, Tomoda Y, Takahashi H, Kakeda S, Takeshita I, et al. Cerebrospinal fluid leakage in intracranial hypotension syndrome: usefulness of indirect findings in radionuclide cisternography for detection and treatment monitoring. Clin Nucl Med. 2008;33:181–5.CrossRefPubMed
5.
go back to reference Thomas DL, Menda Y, Graham MM. Radionuclide cisternography in detecting cerebrospinal fluid leak in spontaneous intracranial hypotension: a series of four case reports. Clin Nucl Med. 2009;34:410–6.CrossRefPubMed Thomas DL, Menda Y, Graham MM. Radionuclide cisternography in detecting cerebrospinal fluid leak in spontaneous intracranial hypotension: a series of four case reports. Clin Nucl Med. 2009;34:410–6.CrossRefPubMed
6.
go back to reference Flynn BM, Butler SP, Quinn RJ, McLaughlin AF, Bautovich GJ, Morris JG. Radionuclide cisternography in the diagnosis and management of cerebrospinal fluid leaks: the test of choice. Med J Aust. 1987;146:82–4.PubMed Flynn BM, Butler SP, Quinn RJ, McLaughlin AF, Bautovich GJ, Morris JG. Radionuclide cisternography in the diagnosis and management of cerebrospinal fluid leaks: the test of choice. Med J Aust. 1987;146:82–4.PubMed
7.
go back to reference Nursal GN, Yapar AF. Demonstration of cerebrospinal fluid leakage on radionuclide cisternography by SPECT/CT. Clin Nucl Med. 2015;40:e55–7.CrossRefPubMed Nursal GN, Yapar AF. Demonstration of cerebrospinal fluid leakage on radionuclide cisternography by SPECT/CT. Clin Nucl Med. 2015;40:e55–7.CrossRefPubMed
8.
go back to reference Semirgin SU, Basoglu T, Cokluk C, Sahin Z. Radionuclide imaging with SPECT/CT in suspected cerebrospinal fluid leakage. Clin Nucl Med. 2012;37:289–92.CrossRefPubMed Semirgin SU, Basoglu T, Cokluk C, Sahin Z. Radionuclide imaging with SPECT/CT in suspected cerebrospinal fluid leakage. Clin Nucl Med. 2012;37:289–92.CrossRefPubMed
9.
go back to reference Pina G, Szathmari A, Scheiber C, Mottolese C. Contribution of SPECT/CT 111In-DTPA cisternography in the localization of an intermittent cerebrospinal fluid leak in a 3-year-old girl with congenital bone defect. Clin Nucl Med. 2011;36:386–8.CrossRefPubMed Pina G, Szathmari A, Scheiber C, Mottolese C. Contribution of SPECT/CT 111In-DTPA cisternography in the localization of an intermittent cerebrospinal fluid leak in a 3-year-old girl with congenital bone defect. Clin Nucl Med. 2011;36:386–8.CrossRefPubMed
10.
go back to reference McKusick KA, Malmud LS, Kordela PA, Wagner Jr HN. Radionuclide cisternography: normal values for nasal secretion of intrathecally injected 111In-DTPA. J Nucl Med. 1973;14:933–4.PubMed McKusick KA, Malmud LS, Kordela PA, Wagner Jr HN. Radionuclide cisternography: normal values for nasal secretion of intrathecally injected 111In-DTPA. J Nucl Med. 1973;14:933–4.PubMed
Metadata
Title
Visual and Quantitative Analysis of Cisternography for the Detection of Cerebrospinal Fluid Leakage
Authors
Eun Kyoung Choi
Jin Kyoung Oh
Sonya Youngju Park
Ikdong Yoo
Dong-Hyun Kim
Yong-An Chung
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 2/2017
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-015-0389-2

Other articles of this Issue 2/2017

Nuclear Medicine and Molecular Imaging 2/2017 Go to the issue