Dyna CT评估直接型颈内动脉海绵窦瘘的临床价值

目的 探讨稀释造影剂增强的Dyna CT评估直接型颈内动脉海绵窦瘘(direct carotid-cavernous fistula,DCCF)的临床价值.方法 收集16例外伤性单瘘口DCCF患者的临床资料,对比分析3D旋转数字减影血管造影(3D-DSA)及稀释造影剂增强的Dyna CT对DCCF的诊断价值,包括对瘘口、软脑膜静脉逆流、引流静脉及海绵窦分隔信息的展示.结果 与3D-DSA相比,Dyna CT多显示了15例(93.75％)患者的21个信息,包括显示瘘口8个,软脑膜静脉的逆向引流2个,引流静脉2个,海绵窦分隔9个.其中,在显示瘘口及海绵窦分隔方面,Dyna CT与3D-DSA差异有统计学意义(P＜0.05);在显示软脑膜静脉的逆向引流和引流静脉方面二者差异无统计学意义.结论 与3DDSA相比,Dyna CT能更有效地显示DCCF的瘘口及海绵窦分隔,利于指导其临床诊治.

Clinical value of Dyna CT in evaluating direct carotid-cavernous fistula

Objective To discuss the clinical value of diluted contrast enhanced Dyna CT in evaluating direct carotid-cavernous fistula(DCCF). Methods The clinical data of 16 patients with traumatic and solo fistulous DCCF were retrospectively studied. The images by 3D rotatory digital subtraction angiography (3D-DSA) and diluted contrast enhanced Dyna CT were used for comparison and analysis of their values for diagnosis of DCCF. The comparison items included information on the orificium fistulae, the retrograde leptomeningeal venous drainage (RLVD), the draining veins and the compartment of the cavernous sinus. Results Compared with 3D rotatory DSA, Dyna CT demonstrated 21 more findings in 15 patients (93.75%), including the detection of the orificium fistulae (n=8), the RLVD (n=2), the draining veins (n=2), and compartment of the cavernous sinus (n=9), with significant difference found between Dyna CT and 3D-DSA in revealing the orificium fistulae and compartment of the cavernous sinus (P<0.05), while not in revealing RLVD and the draining veins. Conclusion Compared with 3D-DSA, Dyna CT can more effectively demonstrate the orificium fistulae and compartment of the cavernous sinus of DCCF, which may benefit the clinical diagnosis and treatment of DCCF.