颈动脉海绵窦瘘的MRI及MRA征象分析(1)
【摘要】 目的探讨颈动脉海绵窦瘘的MRI特点，以提高对该病的认识及评估治疗的作用。方法 回顾分析8例颈动脉海绵窦瘘的临床资料及影像学表现，所有病例均行MRI、MRA、CT及数字减影血管造影(DSA)检查证实，对比分析患者MRI及MRA影像征象。结果 患侧眼球突出8例，海绵窦扩张8例，其中1例为双侧海绵窦扩大，眼上静脉扩张7例，岩上、岩下窦扩张1例，岩上窦扩张1例，眼肌增粗1例，脑挫伤3例。结论颈动脉海绵窦瘘的MRI及MRA具有一定特征性，结合临床对该病的诊断和治疗具有重要的作用。且有成像简单、方便、快捷、无创等优点，是首选的检查方法。
【关键词】颈动脉海绵窦；磁共振成像；磁共振血管成像
Analysis of MR findings of carotid-cavernous sinus fistula
AO Li-ping,GONG Liang-qing,XIAO Xin-lan,et al. People’s Hospital of Xinyu Couty, 338025,China
, http://www.100md.com
【Abstract】 Objective To discuss MR features of carotid-cavernous sinus fistula (CCF), and to strengthen the impression of this disease, so that the accuracy of diagnosis and valuation of therapeutic effect can be improved.Methods Clinical dates and imaging appearances of 8 cases of CCF were analyzed retrospectively. All the cases were performed with MRI, MRA, CT and digital subtraction angiography (DSA). The MRI and MRA appearances were analyzed comparatively. Results 8 patients of CCF all presented with exophthalmos. The MRI and MRA findings included: 8 cases appeared enlargement of cavernous sinus, in which 1 case with enlargement of bilateral cavernous sinuses; dilatation of the superior ophthalmic vein in 7 cases; dilatation of both superior and inferior petrosal sinus in 1 case, and superior petrosal sinus in 1 case; thickening of muscular apparatus in 1 case; and contusion of brain in 3 cases. Conclusions The MRI and MRA appearances of CCF have certain characteristics. Evaluation of imaging appearance conjunction with clinical manifestation is important for the diagnosis and therapy of the disease. MRI is the selective examination for its advantage of simplicity, convenience, quickness and non-invasion.
, 百拇医药
【Key words】 Carotid-cavernous sinus fistula; MRI; MRA
颈动脉海绵窦瘘(caritid-cavrnousfistula,CCF)属脑血管疾病，是指颈内动脉海绵窦段或其分支破裂导致颈内动脉于海绵窦之间形成异常的动静脉沟通。以外伤性多见，占75%～85%[1]。由于眶颅静脉的特殊解剖关系，80%以上的颈动脉海绵窦瘘患者首先表现为眼部症状和体征，患者往往首诊于眼科，偶诊断为眼部其他疾病而延误治疗。该院近年来收治颈动脉海绵窦瘘共8例，全部经CT、MRI、MRA检查并经数字减影血管造影(digital subtraction angiography,DSA)检查证实，分析其征象并对其进行总结如下。
1 材料与方法
1.1 一般资料 收集2002年10月至2007年8月南昌大学第二附属医院共8例颈动脉海绵窦瘘患者，男7例，女1例，年龄6～68岁，平均 32岁，全部病例均有外伤史，病程4 d~1.5年，主要临床症状及体征：不同程度搏动性眼球突出8例，其中血管杂音6例，表现与颈动脉搏动一致，程度不一的吹风样杂音，压迫同侧颈内动脉可使杂音消失，视物模糊6例，复视5例，患者眼睑肿胀，结膜充血水肿5例，眼球运动障碍3例，眼睑下垂2例，脑挫伤、视网膜剥离1例，脑出血3例。
, http://www.100md.com
1.2 检查方法 全部病例均使用GE公司生产的SingaExcite双梯度1.5 T全身磁共振扫描仪，头部线圈完成MRI检查。扫描参数：MR平扫，头颅横断面T1FLAIR脉冲序列，TR 2500 ms,TE 9.3 ms,TI 750 ms，ETL 9个，BW 31.25 Hz，NEX 2，FOV 24 cm，矩阵320×224,层厚5.0 cm，层间距1.5 cm，快速反转恢复自旋回波(FRFSE)TR 4900 ms，TE 102 ms，ETL 21个，BW 31.25 Hz，NEX 2，FOV 24 cm，矩阵320×224，层厚5.0 cm，层间距1.5 cm，冠状面T2 FLAIR TR8500 ms，TE 102 ms，TI 2125ms，ETL 21个，BW 31.25 Hz，NEX 1，FOV 24 cm，，矩阵320×160， 层厚5.0 cm，层间距1.5 cm，然后行TOF-SPGR磁共振血管成像(MRA)，参数：TR 20 ms,TE 6.9 ms, NEX 1，FOV 24 cm，矩阵320×192,翻转角度20°， 层厚1.4 cm，每块重复6层，每块24层。
2 结果
2.1 MRI表现 ①眼球突出：8例于横轴面上患侧眼球均有不同程度的突出，与对侧相比其程度约为4~6 mm(图1)；②海绵窦扩大，8例均表现为患侧海绵窦扩大表现为海绵窦血管流空信号影增多、迂曲、粗大、不规则，正常颈内动脉海绵窦断面结构消失，其中1例双侧扩大，呈血管流空信号(图2)；③眼上静脉扩张：8例均有不同程度的眼上方自前向后外走行的、增粗的条带状流空信号，眼上静脉、内眦静脉迂曲增粗或粗大的流空信号；④眼外肌增厚：1例T2WI上眼肌呈高信号，眼睑肿胀；⑤3例见脑损伤，表现为同侧脑组织肿胀、出血(图3)。, 百拇医药(敖莉萍 龚良庚 肖新兰 袁爱梅 尹建华)
【关键词】颈动脉海绵窦；磁共振成像；磁共振血管成像
Analysis of MR findings of carotid-cavernous sinus fistula
AO Li-ping,GONG Liang-qing,XIAO Xin-lan,et al. People’s Hospital of Xinyu Couty, 338025,China
, http://www.100md.com
【Abstract】 Objective To discuss MR features of carotid-cavernous sinus fistula (CCF), and to strengthen the impression of this disease, so that the accuracy of diagnosis and valuation of therapeutic effect can be improved.Methods Clinical dates and imaging appearances of 8 cases of CCF were analyzed retrospectively. All the cases were performed with MRI, MRA, CT and digital subtraction angiography (DSA). The MRI and MRA appearances were analyzed comparatively. Results 8 patients of CCF all presented with exophthalmos. The MRI and MRA findings included: 8 cases appeared enlargement of cavernous sinus, in which 1 case with enlargement of bilateral cavernous sinuses; dilatation of the superior ophthalmic vein in 7 cases; dilatation of both superior and inferior petrosal sinus in 1 case, and superior petrosal sinus in 1 case; thickening of muscular apparatus in 1 case; and contusion of brain in 3 cases. Conclusions The MRI and MRA appearances of CCF have certain characteristics. Evaluation of imaging appearance conjunction with clinical manifestation is important for the diagnosis and therapy of the disease. MRI is the selective examination for its advantage of simplicity, convenience, quickness and non-invasion.
, 百拇医药
【Key words】 Carotid-cavernous sinus fistula; MRI; MRA
颈动脉海绵窦瘘(caritid-cavrnousfistula,CCF)属脑血管疾病，是指颈内动脉海绵窦段或其分支破裂导致颈内动脉于海绵窦之间形成异常的动静脉沟通。以外伤性多见，占75%～85%[1]。由于眶颅静脉的特殊解剖关系，80%以上的颈动脉海绵窦瘘患者首先表现为眼部症状和体征，患者往往首诊于眼科，偶诊断为眼部其他疾病而延误治疗。该院近年来收治颈动脉海绵窦瘘共8例，全部经CT、MRI、MRA检查并经数字减影血管造影(digital subtraction angiography,DSA)检查证实，分析其征象并对其进行总结如下。
1 材料与方法
1.1 一般资料 收集2002年10月至2007年8月南昌大学第二附属医院共8例颈动脉海绵窦瘘患者，男7例，女1例，年龄6～68岁，平均 32岁，全部病例均有外伤史，病程4 d~1.5年，主要临床症状及体征：不同程度搏动性眼球突出8例，其中血管杂音6例，表现与颈动脉搏动一致，程度不一的吹风样杂音，压迫同侧颈内动脉可使杂音消失，视物模糊6例，复视5例，患者眼睑肿胀，结膜充血水肿5例，眼球运动障碍3例，眼睑下垂2例，脑挫伤、视网膜剥离1例，脑出血3例。
, http://www.100md.com
1.2 检查方法 全部病例均使用GE公司生产的SingaExcite双梯度1.5 T全身磁共振扫描仪，头部线圈完成MRI检查。扫描参数：MR平扫，头颅横断面T1FLAIR脉冲序列，TR 2500 ms,TE 9.3 ms,TI 750 ms，ETL 9个，BW 31.25 Hz，NEX 2，FOV 24 cm，矩阵320×224,层厚5.0 cm，层间距1.5 cm，快速反转恢复自旋回波(FRFSE)TR 4900 ms，TE 102 ms，ETL 21个，BW 31.25 Hz，NEX 2，FOV 24 cm，矩阵320×224，层厚5.0 cm，层间距1.5 cm，冠状面T2 FLAIR TR8500 ms，TE 102 ms，TI 2125ms，ETL 21个，BW 31.25 Hz，NEX 1，FOV 24 cm，，矩阵320×160， 层厚5.0 cm，层间距1.5 cm，然后行TOF-SPGR磁共振血管成像(MRA)，参数：TR 20 ms,TE 6.9 ms, NEX 1，FOV 24 cm，矩阵320×192,翻转角度20°， 层厚1.4 cm，每块重复6层，每块24层。
2 结果
2.1 MRI表现 ①眼球突出：8例于横轴面上患侧眼球均有不同程度的突出，与对侧相比其程度约为4~6 mm(图1)；②海绵窦扩大，8例均表现为患侧海绵窦扩大表现为海绵窦血管流空信号影增多、迂曲、粗大、不规则，正常颈内动脉海绵窦断面结构消失，其中1例双侧扩大，呈血管流空信号(图2)；③眼上静脉扩张：8例均有不同程度的眼上方自前向后外走行的、增粗的条带状流空信号，眼上静脉、内眦静脉迂曲增粗或粗大的流空信号；④眼外肌增厚：1例T2WI上眼肌呈高信号，眼睑肿胀；⑤3例见脑损伤，表现为同侧脑组织肿胀、出血(图3)。, 百拇医药(敖莉萍 龚良庚 肖新兰 袁爱梅 尹建华)