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Intrathecal gadolinium-enhanced MR cisternography in patients with otorhinorrhea: 10-year experience of a tertiary referral center

  • Diagnostic Neuroradiology
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Abstract

Purpose

Despite a considerable amount of literature that has been published about the use of intrathecal gadolinium-enhanced MR cisternography (IGE-MRC), there is still relatively lack of evidence as to its long-term effects. Our purpose in this study was twofold: firstly, to assess the long-term safety of the IGE-MRC; secondly, to evaluate the diagnostic performance of IGE-MRC for detecting cerebrospinal fluid (CSF) leak in otorhinorrhea patients.

Methods

We retrospectively reviewed our imaging and clinical database for the patients admitted to our department for the evaluation of their otorhinorrhea between 2008 and 2017. Two radiologists evaluated the imaging studies independently. Consensus data was used in the analysis. Medical record review and phone call were used for the long-term follow-up.

Results

The retrospective review yielded 166 patients. Rhinorrhea was present in 150 (90.4%) patients and otorrhea in 16 (9.6%) patients. Overall, 67 patients (40.5% of all patients) underwent operation for repair of the CSF leak site. Beta-transferrin test was available and positive in 57 (34.3%) patients. Overall sensitivity of IGE-MRC and paranasal high-resolution CT (HRCT) was 89.3 and 72%, respectively. Within the first 24 h after the procedure, none of the patients experienced a significant complication or adverse reaction. Ninety-nine patients (59.6%) had medical record and telephone follow-up. The mean follow-up duration with call was 37.1 months. Three (3%) patients complained about severe headache 3–4 weeks after the procedure.

Conclusions

IGE-MRC is a minimally invasive and highly sensitive imaging technique. No adverse side effect during our long-term follow-up might strengthen and support the safety of IGE-MRC.

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Authors and Affiliations

  1. Department of Radiology, Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey

    Sebahat Nacar Dogan

  2. Department of Radiology, Division of Neuroradiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey

    Osman Kizilkilic, Civan Islak & Naci Kocer

  3. Department of Radiology, Istanbul Training and Research Hospital, Istanbul, Turkey

    Burak Kocak

  4. Department of Neurosurgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey

    Cihan Isler

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  1. Sebahat Nacar Dogan
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  2. Osman Kizilkilic
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Correspondence to Osman Kizilkilic.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Nacar Dogan, S., Kizilkilic, O., Kocak, B. et al. Intrathecal gadolinium-enhanced MR cisternography in patients with otorhinorrhea: 10-year experience of a tertiary referral center. Neuroradiology 60, 471–477 (2018). https://doi.org/10.1007/s00234-018-2014-4

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