CT、MRI及 MRA 诊断颈内动脉海绵窦瘘价值探讨

摘要

Objective:To explore the CT ,MRI and MRA image features of carotid cavernous fistulas ,and discuss the diagnosis values of CT ,MRI and MRA in carotid cavernous fistulas .Methods:8 patients with carotid cavernous fistula were all scanned by CT ,MRI and MRA .Results:CT and MRI scan showed that 8 patients’s cav‐ernous sinus extended in the affected side ,8 patients’ s uperior ophthalmic vein extended accompanied with exoph‐thalmos ,6 patients had extraocular muscle enlargement ,3 patients had retrobulbar opacification ,7 patients had craniocerebral injury ,among them 7 patients scanned by CT had basicranial fracture .MRA and MIP images of the 8 patients well displayed the location of the orificium of carotid cavernous fistulas ,extended superior ophthalmic vein , inferior ophthalmic vein(in some images) ,superior and inferior petrosal sinus ,cavernous sinus expansion ,and col‐lateral circulation . Conclusion:CT、MRI scan combined with MRA exams are noninvasive ,needing no contrast a‐gent .Therefore they are safe and reliable in the diagnoses of carotid cavernous fistula .%目的：探讨颈内动脉海绵窦瘘的C T、M RI及M RA影像表现，以及各种影像检查方法的诊断价值。方法：对8例颈内动脉海绵窦瘘患者均行CT及MRI平扫、MRA检查。结果：CT 及M RI平扫显示：患侧海绵窦扩大8例，眼上静脉扩张8例，不同程度眼球突出8例，眼外肌增粗6例，球后脂肪浑浊3例，伴有颅脑损伤7例，其中C T 显示颅底骨折7例。8例M RA 原始图像及M IP图像可显示颈内动脉海绵窦瘘口的位置，以及增粗的眼上静脉，部分患者可见眼下静脉、岩上窦、岩下窦、海绵间窦扩张，并可显示侧支循环情况。结论：C T、M RI平扫结合M RA 检查没有创伤，无需对比剂，安全可靠，可以完成对颈内动脉海绵窦瘘的诊断。