彩色多普勒超声与CT、MRI对颈动脉海绵窦瘘诊断价值的对比研究

摘要

Objective To investigate the diagnostic value of color Doppler ultrasound,CT and MR in carotid cavernous fistula(CCF),and to compare their advantages and disadvantages. Methods Ultrasound,CT or MR were performed in 22 patients with CCF,and their imaging features were summarized, the sensitivity,specificity and diagnostic accordance rate of three methods were compared. Results Ultrasound findings of CCF included:dilated superior ophthalmic vein (SOV),reverse flow in the SOV and arterialized flow spectrum. CT and MR showed dilated SOV and cavernous sinus. MRA showed the visualization of carotid and cavernous sinus at the same time,fistulae even be directly showed in some patients. Difference had no statistical significance in sensitivity,specificity and diagnostic accuracy among ultrasound,CT and MR in the diagnosis of CCF. Conclusion Color Doppler ultrasound as a screening method in diagnosing CCF is more suitable for selection compared with other imaging methods,it is worth wide attention and application.%目的：探讨彩色多普勒超声、CT及MRI对颈动脉海绵窦瘘的诊断价值，并比较其优缺点。方法对22例颈动脉海绵窦瘘患者分别行超声、CT或MRI检查，总结各影像学特点，并比较各方法诊断颈动脉海绵窦瘘的敏感性、特异性及诊断符合率。结果颈动脉海绵窦瘘的超声表现：眼上静脉扩张，眼上静脉内见反向彩色血流及动脉化的血流频谱；CT及MRI的表现为眼上静脉扩张及扩大的海绵窦；MRA显示海绵窦与颈动脉可同时显影，部分可直接显示瘘口。超声、CT及MRI诊断CCF的敏感性、特异性及诊断符合率比较，差异均无统计学意义。结论彩色多普勒超声作为一种筛查方法在诊断颈动脉海绵窦瘘方面较其他影像学方法更方便、价廉，值得临床重视和应用。