Magnetic resonance imaging (MRI) cisternography depends on heavily T2-weighted sequences with fat suppression. CSF appears as a bright signal without the need to inject contrast media intrathecally. Furthermore, MRI details the intracranial anatomy and pathology in multiple planes within a relatively short time.
Sequences used for "MRI cisternography Protocol":
- T1 axial/coronal
- T2 axial/coronal
- Heavily weighted T2 coronal fat sat(3mm slice with 0-mm gap)
- If the patient is stable means we can add a rapid EPI coronal T2 weighted will confirm the CSF leaks
The main disadvantage of MRI is its poor spatial resolution and lack of bony details.Thus, CT and MRI seem to be complementary in the diagnosis of CSF leaks.
For ct sometimes difficult to differentiate the csf and sinus opacification and if it is not an active leak or intermittent CSF leaks means sometimes difficult to determine only in CT
Intracraneal hypotension patients also MRI more useful
