To evaluate the role of non-contrast multidetector CT (MDCT) reliability in localizing CSF leaks
and skull base defects in correlation to operative findings.
Materials and methods: Twenty patients clinically diagnosed to have CSF rhinorrhea; 8 spontaneous and
12 post-traumatic patients were evaluated using 64-rows MDCT with slice section 0.6 mm. CT is considered
accurate if correctly determine the site and size of bony defect as matched with operative findings.
Results: MDCT accurately detected the site of presumed CSF leak in 19 out of 20 cases with sensitivity
95%. Cribriform plate defect is the most common site of defect in 40% of cases with 75% of cases categorized
as Keros type II. The consensus image with fair agreement (K = 0.38) shows that coronal reformat
has the highest diagnostic performance in 75% of cases while the least diagnostic value is encountered
with the axial plane in 15% of cases (p = 0.095). There is almost a perfect agreement (K = 0.810) between
the MDCT measurements and operative size of bony defect with minimal difference in 10% of patients
(P < 0.001).
Conclusion: Non-contrast MDCT is an accurate reliable non-invasive imaging modality for preoperative
evaluation of CSF rhinorrhea