海绵窦病变的MRI诊断

MR imaging in the diagnosis of the cavernous sinus diseases

目的:探讨海绵窦病变的MRI影像表现。材料和方法:51例经临床证实的海绵窦病变患者行MRI检查,选择轴位、冠状位及矢状位扫描;病变包括海绵窦区炎症6例、颈内动脉(ICA)海绵窦瘘5例、颈内动脉瘤5例、侵袭性垂体瘤10例、鼻咽部肿瘤11例、鞍旁脑膜瘤3例、颞叶间变性胶质瘤3例、三叉神经瘤5例、海绵窦转移瘤3例。结果:①全部51例病变侧海绵窦均可见异常信号影,病变侧海绵窦扩大,两侧不对称。②10例血管性疾病海绵窦内均可见异常血管流空影。③在6例海绵窦炎症及35例肿瘤性病变中,共有18例双侧海绵窦受累,23例单侧海绵窦受累;其中双侧ICA完全被病变组织包绕者14例,单侧ICA完全被包绕者2例,单侧ICA大部或部分被包绕者14例。结论:MRI能清楚显示海绵窦区的病变,表现为海绵窦双侧不对称,病变侧海绵窦扩大,形态及信号异常;ICA受压变形移位,部分或完全被病变组织包绕。

Objective:To study MR findings in the diagnosis of the cavernous sinus(CS)diseases.Materials and Meth-ods :Fifty-one patients clinically proven to have CS lesions underwent MR examination,including six cases of inflammatory diseases,ten cases of vascular diseases,35cases of tumorous lesions.Results:①Abnormalities were detected on MRI in all51patients,CS was asymmetrically in shape,the involved side enlarged,signal abnormal.②The flow void-sign was seen in both ICA aneurysm and ICA-CS fistula as well as enlargement of the CS on the diseased side.③In six cases of inflammatory dis-eases and35cases of tumorous lesions,the involvement of CS were bilateral in18cases,unilateral in23cases,and the bilater-al internal carotid artery(ICA)were totally encased by pathological tissue in14cases,unilateral ICA was partially encased in14cases,and totally in two cases.Conclusion:The involvement of CS can be displayed clearly on MRI ,the involved side of CS enlarged,signal and shape abnormal,ICA is suppressed,totally or partially encased by diseased tissue.