多层螺旋CT、MRI、DSA对颈动脉海绵窦瘘的诊断价值(附8例报告)  

Diagnostic value of MSCT、MRI、DSA for carotid-cavernous sinus fistulae(A report of 8 cases)

作　　者：林笑丰[1] 谢榜昆[1] 陈玥瑶[1] 黄云海[1] 杨绮华[1] 

机构地区：[1]中山大学第二附属医院放射科,510120

出　　处：《岭南现代临床外科》2007年第6期457-460,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨多层螺旋CT(MSCT)、MRI和数字减影血管造影(DSA)等影像学检查在颈动脉海绵窦瘘(CCF)诊断中的价值。方法回顾性分析我院经外科及血管内栓塞治疗成功的CCF共8例,行MSCT检查5例,MRI检查5例,两者同时检查2例,所有病例均行DSA检查。结果MR、CT主要表现:所有患者眼球突出、海绵窦扩大、患侧眼上静脉扩张,部分患者眼下静脉、内眦静脉、面静脉、小脑半球上表面外侧脑膜静脉扩张,岩上、下窦扩张,眼外肌肿胀,眼球壁增厚。DSA主要表现:患侧海绵窦扩大,患侧眼上静脉充盈扩张,并可发现瘘口、引流静脉及盗血现象。结论CT、MRI、DSA检查均可独立作为诊断CCF手段,CTA和MRA技术在诊断领域内一定程度上可替代DSA。但DSA提供CCF血流动力学改变情况,仍是诊断CCF的金标准,不可完全取代。Objective To investigate the value of Multi-slice spiral CT （MSCT）,MRI and digital subtraction angiography （DSA）in the diagnosis of carotid-cavernous sinus fistulae （CCF）. Methods Eight cases with CCF patients were cured by surgery or intravascular embolization. Five of them were examined by MSCT and five of them were examined by MRI. Two of them were examined by MSCT and MRI. All of them were examined by DSA. Results The main MRI and CT findings of CCF included exophthalmus, enlarged cavernous sinus and engorged superior ophthalmic vein（SOV） in the involved side in all cases. Dilatation of the inferior ophthalmic vein,facial vein, angular vein,cerebellar veins, superior petrosal sinus,inferior pertrosal sinus and hypertrophy of extra ocular muscle,eyeball wall were found in some cases. The main DSA findings of CCF included enlarged cavernous sinus and engorged superior ophthalmic vein in the involved side,and it was enable to correctly locate the fistula, discoverred ＂steal flow＂ phenomenon. Conclusion CT, MR and DSA can diagnose CCF independently. MSCTA and MRA can be used instead of DSA in diagnosis aspect. But DSA can display the cerebral vessels hemodynamics caused by CCF, and it is the gold standard which can＇t be replaced completely.

关 键 词：颈动脉海绵窦瘘 体层摄影术 血管造影术 数字减影 

分 类 号：R445[医药卫生—影像医学与核医学]