| It is known as CSF fistula that the CSF runs off from the nostril or ear way after cerebral trauma. CSF fistula is the familiar complication of cerebral trauma. The rate of its occurrence lies in 2 - 9%. Patients with traumatic CSF fistula all have base skull fracture and dura leakage , therefore, we can make sure that the liquid out from nostril or ear way are CSF if the fracture line crossing the paranasal sinus or mastoid and the local accumulating liquid in the cave of paranasal sinus or mastoid. CSF fistula is the important reason for the maturation meningitis. If it can't heal by itself, the operation to close the dura leakage will be necessary. So as to confirm the diagnosis of CSF fistula and to judge the position of the dura leakage are the major mission of imaging examination.The common CT cant directly display the dura leakage. CT cis-ternography and radionuclide cistemography are commonly used technique to precise the location, number and size of fistula. Radionuclide cistemography can' t display the skull lesion. CT cistemography can display either the dura leakage or the skull lesion, so it is the better technique. But the sensitivity of CTC to the intermittent or mute CSF fistula is low, especially when the dura leakage is smaller than 2mm. MR cistemography can precisely display the position and number ofdura leakage, and it has higher sensitivity than CTC especially to the dura leakage which size is smaller than 2mm. But MR can' t well display the skull lesion, and many studies indicate that its specificity to display the dura leakage is low. Also many studies indicate that MRC and high - resolution CT appear to be complementary, applying these two techniques can either precisely display the skull lesion or improve sensitivity and specificity to display the dura leakage, and can precisely display the dura lesion. As a noninvasive technique, now it is the best. Therefore CT exam has important value for CSF fistula. The longitudinal resolution of multi - slice CT is improved to reach the iso-tropic spatial resolution. And it will be more fit to exam the CSF fistula. The aim of this study is to evaluate the value of multi - slice CT in diagnosis of CSF fistula with three - dimension post - processing technique.Material and methodFrom 2001.4 to 2002. 3 multi - slice CT were performed on 31 patients with traumatic CSF fistula in the First Attached Clinical Hospital of China Medical University. 29 were male, 2 were female. The media age was 35 years (range 13 -53).CT scans were performed on multi - slice CT Aquilion ( Toshiba Medical System) from teeth to 2cm above orbit. Collimation 1mm, pitch 3.5, reconstructed slice thickness 1.0mm, reconstructed interval 1.0mm, FC30. Three -dimension images were performed at the workstation (software ALATOVIEW 1.42) with MPR, CVR functions. The MPR image with 0.4mm slice thickness was as the multi -slice CT diagnosis image, the CVR image with 2mm and 5mm slicethickness were as the SCT and CCT diagnosis image to emulate the single - slice helical CT and conventional CT conditions.CT images were reviewed by two radiologists specializing in head radiology. CT criteria for diagnosis of CSF fistula included: (1) fracture line. (2) liquid accumulating in the cave of paranasal or mastoid where the fracture line passed. (3) encephalic accumulating air. (4) encephalic eyewinker.ResultsMSCT images displayed all cases with skull fracture, but SCT and CCT images only displayed 25(80.6% ) and 19(61.3% ) of 31. And cases with fracture all had liquid accumulating in the cave of paranasal or mastoid where the fracture line passed. MSd\ SCT and CCT images all displayed 7 cases with encephalic accumulating air and 1 case with encephalic eyewinker. MSCT images displayed 70 fracture lines, SCT and CCT images only displayed 64 and 58 fracture lines. MSCT^SCT and CCT images were same to display the fracture lines on frontal bone ^ orbit and temporal bone. MSCT images displayed 22 fracture lines passing the ethmoid sinus, at same time SCT and CCT images disp...
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