海绵窦病变的影像学表现及临床意义

Imaging Manifestation and Clinical Value of Cavernous Sinus Diseases

目的:分析海绵窦区病变的影像学表现及其价值。方法:回顾性分析经临床及病理确诊53例海绵窦病变的影像表现,其中侵袭性垂体瘤15例,鼻咽癌14例,脊索瘤4例,颅咽管瘤4例,脑膜瘤3例,三叉神经瘤3例,颈内动脉海绵窦瘘7例,颈内动脉瘤3例。结果:(1)43例肿瘤性病变表现为海绵窦区异常密度及异常信号肿块影,海绵窦变形、不对称。双侧海绵窦受累11例,一侧海绵窦受累32例;其中双侧颈内动脉被包绕5例,单侧颈内动脉被包绕14例。(2)10例海绵窦血管性病变中,均出现异常血管流空,3例动脉瘤表现为类圆形稍高密度影,7例颈内动脉海绵窦瘘同侧眼上静脉扩张扭曲(≥3mm),DSA示颈内动脉海绵窦段显影时同侧海绵窦显影。结论:影像学检查对海绵窦病变的诊断及鉴别诊断具有重要意义,能了解颈内动脉海绵窦段是否被包绕,为临床治疗方案的选择提供理论依据。

Objective：To analyze imaging manifestation and value of cavernous sinus（CS）diseases.Methods：Imaging findings of fifty-three patients with CS diseases proved by clinical and histopathologic findings were analyzed retrospectively,including invasive pituitary tumor 15 cases,nasopharynigeal carcinoma 14 cases,chordoma 4 cases,craniopharyngioma 4 cases,meningioma 3 cases,trigeminal neuromas 3 cases,carotid-cavernous fistula（CCF）7 cases and internal carotid artery（ICA）anuerysm 3 cases.Results：（1）Abnormal density and signal masses were seen in 43 tumorous lesions,CS was asymmetrical in shape and distortion.the involvement of CS were bilateral in 11 cases,unilateral in 32 cases,bilateral ICA were encased in 5 cases,unilateral ICA was encased in 14 cases.（2）10 cases vascular lesions showed abnormal flow void-sign,round-like hyper-density in 3 aneurysms,enlargement of the superior ophthalmic veins（≥3 mm）in 7 CCF.CS was also seen when DSA displayed ICA cavernous segment in CCF patients.Conclusion：Imaging examination plays an important role in diagnosis and differential diagnosis of CS diseases,can show whether ICA cavernous segment was encased,and it is helpful for establishing accurate treatment project.