多层螺旋CT血管成像诊断颈动脉海绵窦瘘

目的探讨颈动脉海绵窦瘘(CCF)的解剖病理基础及螺旋CT血管成像(MSCTA)表现,提高MSCTA对CCF的诊断能力。方法12例经DSA证实的CCF均进行了螺旋CT平扫、增强扫描及血管成像重建。结果CCF的MSCT及CTA表现为:海绵窦扩大及眼上静脉扩张12例,并与颈内动脉同时显影;其他属支静脉扩张6例;对侧海绵窦扩大4例,与DSA检查结果一致。患侧眼球突出12例。颅底、眶壁骨折5例。眼球壁模糊、增厚5例。脑挫伤、出血4例。眼外肌增粗1例。结论螺旋CT及其血管成像诊断CCF简单、快捷、准确、可靠,特别是在外伤性CCF中,是首选的检查及诊断方法。

Carotid-cavernous fistula: diagnosis with multi-slice spiral CT angiography

Objective To improve the diagnostic ability of multi-slice spiral CT angiography(MSCTA) in carotid-cavernous fistula(CCF) by investigating its anatomic-pathological bases and MSCTA findings of CCF.Methods Twelve cases of CCF finally confirmed by DSA were performed by precontrast and enhancement CT and MSCTA reconstruction.Results The MSCT and CTA findings of CCF were as following: twelve cases of enlarged cavernous sinus and superior ophthalmic vein,which visualized simultaneously with internal carotid artery,six cases of enlarged other belonged veins,four cases of enlarged contralateral cavernous sinus,the results were conformity with DSA;twelve cases of exophthalmus;five cases of fracture on bases of skull and orbital wall;five cases of vague and thickened eyeball;four cases of brain contusion and hemorrhage;one case of thickened extraocular muscles.Conclusion MSCT and CTA are the simple,fast,accurate and reliable methods for the diagnosis of CCF,and are the first choice especially in traumatic CCF.