MR-Cisternography
with T2-Weighted Single-Shot
Fast Spin Echo Sequence
in
the Diagnosis of a Spontaneous
CSF Fistula of the Sphenoid
Sinus Causing Massive Pneumocephalus SUMMARY – A spontaneous CSF fistula of the sphenoid sinus was preoperatively diagnosed in a young woman presenting with massive pneumocephalus and rhinorrhea. Diagnosis was established by MR cisternography using a heavily T2-weighted 3D single-shot FSE sequence with half-Fourier analysis (3D-EXPRESS®), originally developed for imaging the inner ear. While unenhanced CT failed to detect the site of the fistula, MR permitted complete evaluation of the sellar/sphenoid region and tracked the CSF signal down to the nasal cavity. |