Imaging analysis of the spontaneous cerebrospinal fluid rhinorrheas associated with empty sella

Objective To study the prevalence of empty sella in spontaneous cerebrospinal fluid rhinorrheas patients with CT and/or MRI.Methods The Imaging data of 22 patients with spontaneous cerebrospinal fluid rhinorrheas(MR in 22 patients and CT in 18 patients)were retrospectively analyzed.Leaks identified with CT and MRI were compared with that observed through endoscopic sinus surgery.Results Twenty-four leaks were confirmed with endoscopic sinus surgery in 22 patients,one of which had 3 leaks.In 20 leaks of 18 patients,CT demonstrated 11 bone defects(11/20,55.00%).In 24 leaks of 22 patients,coronal MR T2WI displayed 13 leaks(13/24,54.17%),and coronal T2WI MR cisternography(MRC)revealed 20 leaks(20/24,83.33%).The sella turcica were enlarged and filled with cerebrospinal fluid on CT in 17 patients(94.44%).MRI showed abnormal increase of cerebrospinal fluid inside the sella and the compressed pituitary gland in all the 22 patients,of which 16(72.73%)showed complete empty sella and 6(27.27%)in partial empty sella.Coronal MRC demonstrated the enlargement of perioptic subarachnoid space in 17 patients(77.27%).In addition,there was no statistical significance of disease course between complete empty sella and partial empty sella(P=0.60).Conclusion The imaging demonstrates the spontaneous cerebrospinal fluid rhinorrheas are all accompanied with empty sella,indicating that empty sella can be regarded as a significant accompanying imaging feature for the diagnosis of spontaneous cerebrospinal fluid rhinorrheas.