Abstract | OBJECTIVE: STUDY DESIGN: Retrospective imaging review. SETTING: Academic medical center. SUBJECTS: METHODS: Patients were assigned to cerebrospinal fluid leak and other effusion cohorts based on clinical course, findings at surgery/myringotomy, and beta-2 transferrin fluid analysis. Reviewers blinded to the clinical outcome examined T1-weighted, T2-weighted, diffusion-weighted, fluid-attenuated inversion recovery (FLAIR), and 3-dimensional (3D) acquired T2-weighted MRI sequences. For each sequence, fluid imaged in the temporal bone was graded as either similar or dissimilar in signal intensity to cerebrospinal fluid in the adjacent subarachnoid space. Signal similarity was interpreted as being diagnostic of a leak. Test characteristics in predicting the presence of a leak were calculated for each series. RESULTS: Eighty patients met criteria (41 leaks, 39 other effusions). The 3D T2 series was 76% sensitive and 100% specific in diagnosing a leak, and FLAIR was 44% sensitive and 100% specific. The T1-weighted (73% sensitive, 69% specific), T2-weighted (98% sensitive, 5.1% specific), and diffusion-weighted (63% sensitive, 66% specific) series were less useful. CONCLUSIONS:
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Authors | Joseph T Breen, Colin R Edwards, Rebecca S Cornelius, J Michael Hazenfield, Gavriel D Kohlberg, Ravi N Samy, Myles L Pensak |
Journal | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
(Otolaryngol Head Neck Surg)
Vol. 161
Issue 3
Pg. 493-498
(09 2019)
ISSN: 1097-6817 [Electronic] England |
PMID | 31039071
(Publication Type: Journal Article)
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Topics |
- Cerebrospinal Fluid Leak
(diagnostic imaging)
- Diagnosis, Differential
- Humans
- Magnetic Resonance Imaging
- Otitis Media with Effusion
(diagnostic imaging)
- Retrospective Studies
- Sensitivity and Specificity
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