动脉瘤性颈内动脉海绵窦瘘的临床与影像学表现

Clinical and imaging manifestations of aneurysmal carotid-cavernous fistula

目的:总结颈内动脉海绵窦段动脉瘤破裂导致颈内动脉海绵窦瘘(CCF)的临床及影像学表现,以期指导诊断。方法:回顾性分析2003年5月～2010年12月收治的9例颈内动脉海绵窦段动脉瘤破裂致CCF患者的临床资料以及影像学检查结果。结果:9例动脉瘤性CCF,7例为女性,2例为男性,均为突发颅内搏动性杂音或眼部症状。头部CT/MRI均可见患侧眼球突出,眼上静脉增粗,以及海绵窦动脉瘤征象。脑血管造影(DSA)表现上与外伤性CCF相似,不同之处是动脉早期可见海绵窦段动脉瘤。结论:动脉瘤性CCF多为突发起病,表现为颅内搏动性杂音以及眼部症状。CT、MRI有助于初步诊断,DSA是其诊断的"金标准"。

Objective：To study the clinical and imaging manifestations of aneurysmal carotid cavernous fistula （CCF） in order to guide the diagnosis of this disease. Methods： Retrospectively analyzed the clinical and imaging manifestations of nine patients with aneurysmal CCF due to rupture which were treated from May 2003 to December 2010. Results：Of all nine patients with aneurismal CCF, including seven females and two males, presented with a sudden occurrence of intracranial pulsatile murmurs or eye symptoms. CT and MRI images showed ophthalmoptosis,increased diameter of superior ophthal mic vein and the manifestation of aneurysm at the carotid-cavernous segment. The appearances of digital subtract angiogra- phy （DSA） were similar to that of traumatic CCF,while the difference was that carotid-cavernous segment aneurysm could be seen at early arterial phase. Conclusion= Aneurysmal CCF mostly presented as sudden onset with intracranial pulsatile murmurs and eye symptoms. CT and MRI are helpful for preliminary diagnosis, while I）SA is the ＂golden standard＂ for final dia^nn^i~