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Imaging in the Work-Up of CSF Leak

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CSF Rhinorrhea

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Abstract

In the diagnostic/pre-operative work-up of cerebrospinal fluid rhinorrhea imaging plays a key role. The localization of the site(s) of the leak is the most obvious main goal of the radiologic investigation, but there are several other critical issues that a proper imaging study can address. Two are the imaging techniques mainly indicated: computer tomography (CT) and magnetic resonance (MR). CT explores bony structures with fine detail, but it has low soft-tissue resolution. Conversely, MR can differentiate and characterize a wide range of soft tissues and fluids, allowing to directly visualize a CSF leakage. It is up to the radiologist to choose the imaging study (or the combination) most suitable for each specific situation. In fact, there is no standard study protocol that can fit all possible patients. Nevertheless, with just a few general indications in mind an informative exam can be obtained with relative ease.

Performing a high-quality exam, though, is just the first part of the job for the radiologist. The next step is the analysis/interpretation of the images. To meet this target, the knowledge of the etiology of the rhinorrhea is of paramount importance, since different etiologies imply different reasoning for the correct interpretation of the radiological images.

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Authors and Affiliations

  1. Department of Radiology, ASST Spedali Civili and University of Brescia, Brescia, Italy

    Roberto Maroldi & Giovanni Palumbo

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  1. Roberto Maroldi
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  2. Giovanni Palumbo
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Correspondence to Roberto Maroldi .

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Editors and Affiliations

  1. Department of Otorhinolaryngology, King Fahd Medical City, Riyadh, Saudi Arabia

    Abdulaziz A. AlQahtani

  2. Department of Otorhinolaryngology, University of Insubria, Varese, Varese, Italy

    Paolo Castelnuovo

  3. Department of Otolaryngology, Head and Neck Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA

    Roy Casiano

  4. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Ricardo L. Carrau

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Maroldi, R., Palumbo, G. (2022). Imaging in the Work-Up of CSF Leak. In: AlQahtani, A.A., Castelnuovo, P., Casiano, R., Carrau, R.L. (eds) CSF Rhinorrhea. Springer, Cham. https://doi.org/10.1007/978-3-030-94781-1_6

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