颈动脉海绵窦瘘的MRI诊断(附12例报告)

目的分析颈动脉海绵窦瘘(CCF)的MRI表现及诊断价值。方法搜集近年有完整临床资料的CCF12例进行MRI表现的回顾性分析。其中男8例，女4例；外伤性CCF11例，自发性1例，均由DSA造影证实。结果MRI主要表现为：(1)眼球突出11例；(2)海绵窦扩大12例；(3)眼上静脉扩张、迂曲11例，蝶顶窦和大脑中、浅静脉扩张2例，岩上窦和岩下窦扩张2例，眼下静脉和眼睑静脉扩张1例；(4)眼外肌增粗3例；(5)脑萎缩3例，脑水肿和脑出血2例。结论MR检查是一种无创伤的诊断CCF的方法，具有准确、方便、特异性高等优势，能明确病变部位及程度，但应进行必要的鉴别诊断。

MRI diagnosis of carotid cavernous fistula:a report of 12 cases

Objective To analyze MR findings and its diagnostic value in carotid cavernous fistula (CCF).Methods Twelve cases of CCF finally substantiated by DSA were retrospectively analyzed. Of all the patients, 8 were males and 4 females. Traumatic and spontaneous CCF were noted in 11 cases and 1 case, respectively.Results The main MR findings were as follows: (1) Eleven cases of exophthalmus. (2) Twelve cases of enlarged cavernous sinus. (3) Eleven cases of enlarged superior ophthalmic vein, 2 cases of dilatation of sphenoparietal sinus with outstretched cerebral medial and superficial veins, 2 cases of dilatation of superior and inferior petrosal sinuses, and 1 case of dilatation of inferior ophthalmic vein and palpebral vein. (4) Three cases of hypertrophy of extra ocular muscle. (5) Three cases of regional encephalatrophy, 2 cases of regional encephaledema and cerebral hemorrhage.Conclusion MRI can non-invasively and precisely diagnose CCF, and it plays an important role in the evaluation of pathological extent and region of CCF, but differential diagnosis is still necessary.