Diagnostic Accuracy of Combined High-Resolution Computed Tomography and MR Cisternography in Evaluation of CSF Rhinorrhea Patients, Taking Surgical Findings As Gold Standard

Objective: To determine the diagnostic accuracy of combined high-resolution computed tomography and MR Cisternography in evaluation of CSF rhinorrhea patients, taking surgical findings as gold standard. Methodology: The Observational Cross-sectional study was conducted at Benazir Bhutto and Holy Family Hospital, Rawalpindi for a total period of 12 months from 1 June 2022 to 1 May 2023. All patients having CSF rhinorrhea (discharge of cerebrospinal fluid (CSF) from the nose) of >1-month duration was enrolled and underwent HRCT/MR cisternography subsequently followed by surgery and results of both modalities were compared. Results: Out of a total of 156 patients enrolled, 136 (87.1%) were males and 20 (12.8%) females. The results of this study yielded a sensitivity of 93.3%, specificity of 61.9%, positive predictive value of 94% and a negative predictive value of 59%. The overall accuracy of combined HRCT/MR Cisternography for the diagnosis of CSF rhinorrhea was found to be 89.1% in comparison to surgery. Conclusion: The use of Combined HRCT/MR cisternography for the diagnosis of CSF rhinorrhea is a feasible, safer and highly accurate modality for correctly identifying such cases and circumvents the limitations imposed by the use of any single modality in these patients.