Evaluation of intrathecal gadolinium-enhanced MR cisternography in a rabbit model of traumatic nasoethmoidal CSF fistula.

This pilot study details the feasibility of intrathecal gadopentetate dimeglumine (Gd) administration in the detection of posttraumatic cerebrospinal fluid (CSF) fistula in an animal model. Five rabbits were used in this study. An attempt was made to create a traumatic CSF fistula surgically via a nasal approach. Seven days following the procedure, images of the cranium in sagittal and coronal planes were obtained utilizing a 1.9 T magnetic resonance (MR) imaging scanner before and after intrathecal injection of 16 pmol Gd. Following the imaging study, the animals were euthanized and grossly sectioned coronally to search for fistula formation. One animal died on the third day following the surgical procedure. The other four rabbits underwent the MR and gross pathologic study. Diagnosis of the fistula by intrathecal Gd-enhanced MR imaging was successful in two rabbits; this finding was confirmed by gross pathologic examination. No fistula was detected on either intrathecal Gd-enhanced MR imaging or on pathologic study in the remaining two rabbits. Intrathecal enhanced MR cisternography is a potentially promising technique for the evaluation of posttraumatic CSF fistulae.