MRI Head MRI with the inclusion of heavily T2-weighted images is often referred to as an MR cisternogram and is considered the second choice of study and should be done only in conjunction with HRCT [12,55,61]. The heavily T2-weighted sequence covering the roof of the sinonasal cavity in the coronal plane can be included in either an MRI head examination or an MRI orbits, face, and neck examination. A 3-D isotropic heavily T2-weighted sequence should be obtained to provide submillimeter high spatial and contrast resolution and allow for reformats in multiple planes. The site of the CSF leak can be demonstrated on MRI with identification of CSF extending from the subarachnoid space into the sinonasal space through an osseous defect seen on a concurrent or prior CT examination, with or without an associated cephalocele. Sensitivity of 56% to 94% and specificity of 57% to 100% have been reported Sinonasal Disease for the identification of the site of the CSF leak [12-14,55,58,61,63]. Given its superior soft-tissue contrast, MRI can also identify the contents of a cephalocele if present. MRI without IV contrast with inclusion of heavily T2-weighted images is typically sufficient for the evaluation of CSF leak. However, MRI without and with IV contrast may be useful for identifying dural enhancement and distinguishing a meningoceles from sinus secretions [11]. MRI Orbits, Face, and Neck MRI with the inclusion of heavily T2-weighted images is often referred to as an MR cisternogram and may be considered the second choice of study and should be done only in conjunction with HRCT [12,55,61]. The heavily T2-weighted sequence covering the roof of the sinonasal cavity in the coronal plane can be included in either an MRI head examination or an MRI orbits, face, and neck examination. A 3-D isotropic heavily T2-weighted sequence should be obtained to provide submillimeter high spatial and contrast resolution and to allow for reformats in multiple planes.
Sinonasal Disease. MRI Head MRI with the inclusion of heavily T2-weighted images is often referred to as an MR cisternogram and is considered the second choice of study and should be done only in conjunction with HRCT [12,55,61]. The heavily T2-weighted sequence covering the roof of the sinonasal cavity in the coronal plane can be included in either an MRI head examination or an MRI orbits, face, and neck examination. A 3-D isotropic heavily T2-weighted sequence should be obtained to provide submillimeter high spatial and contrast resolution and allow for reformats in multiple planes. The site of the CSF leak can be demonstrated on MRI with identification of CSF extending from the subarachnoid space into the sinonasal space through an osseous defect seen on a concurrent or prior CT examination, with or without an associated cephalocele. Sensitivity of 56% to 94% and specificity of 57% to 100% have been reported Sinonasal Disease for the identification of the site of the CSF leak [12-14,55,58,61,63]. Given its superior soft-tissue contrast, MRI can also identify the contents of a cephalocele if present. MRI without IV contrast with inclusion of heavily T2-weighted images is typically sufficient for the evaluation of CSF leak. However, MRI without and with IV contrast may be useful for identifying dural enhancement and distinguishing a meningoceles from sinus secretions [11]. MRI Orbits, Face, and Neck MRI with the inclusion of heavily T2-weighted images is often referred to as an MR cisternogram and may be considered the second choice of study and should be done only in conjunction with HRCT [12,55,61]. The heavily T2-weighted sequence covering the roof of the sinonasal cavity in the coronal plane can be included in either an MRI head examination or an MRI orbits, face, and neck examination. A 3-D isotropic heavily T2-weighted sequence should be obtained to provide submillimeter high spatial and contrast resolution and to allow for reformats in multiple planes.