Magnetic Resonance Imaging in Basal Skull Fracture.

概要

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Nineteen patients who had been clinically diagnosed as having basal skull fracture were studied by magnetic resonance imaging (MRI) within 3 days after injury. Patient age ranged from 2 to 72 years with a mean of 29.2 years. MRI was performed using a HITACHI MRP-20 (0.2 Tesla) or a TOSHIBA MRT-50A (0.5 Tesla) system. The location of the basal skull fracture was in the frontal bone in 3 patients, the temporal bone in 14 patients and the sphenoid bone in 2 patients. MRI did not enable direct visualization of the basal skull fracture, but in 17 of the 19 patients the presence of a fracture was ascertained after as the detection on MRI of hemorrhage complicating the fracture, which appeared as a high intensity area in the paranasal sinus or in the pyramidal bone. In contrast, there were only 5 patients in whom it was possible to confirm basal skull fracture by high resolution CT. Furthermore, it is difficult to confirm the site and pathway of a cerebrospinal fluid (CSF) leak resulting from basal skull fracture by CT. MRI involves no artifacts in bony structures and reveals CSF leakage as a high intensity area similar to the image intensity of CSF by T2-weighted imaging. MRI was considered for the diagnosis of basal skull fractures and for detecting the sites and pathways of CSF leakage.
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