Detection and Management of Skull Base Cerebrospinal Fluid Leaks Using HRCT-MRI Fusion Imaging

Abstract

Background: Endoscopic repair of cerebrospinal fluid (CSF) leaks has been well described in the literature as an effective method for the treatment of sinonasal skull base defects. However, despite the ongoing evolution of the endoscopic techniques for repair, site localization is a diagnostic challenge. The limitations and morbidity associated with diagnostic imaging studies such as high-resolution computer tomography (HRCT), magnetic resonance imaging (MRI), and computed tomography (CT) cisternography in detecting CSF leaks has created a need for more accurate and less invasive radiographic imaging modalities. In our study, we evaluate a novel technique of fusing HRCT and MRI imaging for the detection of CSF leaks, as well as its ability to aid in intraoperative localization of skull base defects through computer-assisted image guidance.