Tolosa-Hunt综合征的MRI诊断及其临床价值

MRI Diagnosis and Clinic Value of Tolosa Hunt Syndrome

目的探讨Tolosa-Hunt综合征(THS)的MRI征象及其临床价值。资料与方法对13例经临床确诊的THS患者行MRI检查,分别选取矢状位、轴位及冠状位扫描,并行Gd-DTPA增强扫描,2例加作磁共振血管成像三维时间飞跃法(3D-TOFMRA)。结果全部病例均为单侧发病,表现为病变侧海绵窦形态发生改变,在T1WI上呈等或稍低信号,T2WI呈稍高信号,边缘清楚,颈内动脉(ICA)被包绕,管腔不同程度变窄,增强扫描病灶明显强化。治疗后病灶缩小或消失,增强扫描强化程度减低。结论THS的MRI表现有一定的特征性,其不仅能显示病变的范围为诊断和鉴别诊断提供客观依据,还是治疗后随访的最佳方法。

Objective To discuss the MRI features of Tolosa Hunt syndrome and its clinical value. Materials and Methods 13 cases of THS diagnosed by clinic received. MRI scan using SE sequence on T1WI sagittal and FSE on T2WI coronal plane, and FSE on T2WI axial plane respectively, all cases were performed Gd DTPA enhanced MR imaging and MRA 3D-TOF were added in 2 cases. Result All lesions were located at only one side of cavernous sinus, the shape of cavernous sinus was changed with hypo or isointensity on T1W and hyperintensity on T2W. The enhancement after Gd DTPA injection was remarkable . The internal artery （ICA） was partly or totally encased and the lumen was narrow. After effective treatment, enhancement reduced, lesions became smaller or disappeared. Conclusion There are several MRI features on THS. MRI can clearly show surrounding structures and the invaded extent, which is helpful to diagnose and evaluate the response to treatment.