海绵窦型硬脑膜动静脉瘘

目的 探讨海绵窦型硬脑膜动静脉瘘的最佳检查与治疗方法。方法对比分析34例该病患者各种检查及血管内栓塞治疗的结果。结果CT检查阳性9例；MRI、MRA检查阳性表现23例；3D-TCD检查有24例表现患侧眼静脉流速升高；DSA检查可以清楚地反应海绵窦型硬脑膜动静脉瘘的全貌。34例患者有17例获解剖学治愈，4例临床治愈，10例好转，1例出现偏瘫，2例未治。结论DSA是确诊海绵窦型硬脑膜动静脉瘘的金标准，能显示出瘘口的类型、血供及静脉引流方式：CT、MRI、MRA及3D-TCD只能反应部分颅内继发性改变。血管内栓塞是目前治疗海绵窦型硬脑膜动静脉瘘唯一安全有效的方法。

Dural arteriovenous fistula involving cavernous sinus

Objective To investigate the optimal examination and treatmen t of the dural arteriovenous fistula (DAVF) involving cavernous sinus. Method s A retrospective review on clinic data of 34 cases diagnosed as DAVF involvi ng cavernous sinus was done to analyze and compare the characteristics of DAVF o n several examinations such as CT, MR, TCD and DSA. Results The positive r ates were 26.5% and 82.4% by CT and MR, respectively. The blood flow rate of the ophthalmic vein at the affected side rose in 24 cases. DSA could best show the whole picture of the vascular abnormalities of DAVF involving cavernous sinus. O f the 34 cases, 17 cases were cured anatomically, 4 cases clinically, and 10 cas es were improved, besides 1 case coming out with hemiplegia and 2 receiving no t reatment. Conclusion DSA, as the standardized approach for the diagnosis o f DAVF involving cavernous sinus, can satisfactorily demonstrate the orifices of fistulas, feeding arteries, and venous drainage while CT, MR, TCD can delineate part of the intracranial vascular abnormalities and secondary anomalies. Endova scular embolization is solely safe and effective in the treatment of DAVF involv ing cavernous sinus at present