Wang Yi, Xiao Li-hua
Institute of Orbital Disease, Armed Police General Hospital, Beijing 100039, China.
Zhonghua Yan Ke Za Zhi. 2004 Oct;40(10):674-8.
To evaluate the value of ultrasonography, CT, MRI and digital subtraction angiography (DSA) in the diagnosis of carotid cavernous fistula (CCF).
Twenty-eight cases of CCF patients were examined with ophthalmologic A/B echography and DSA, part of them were examined by one or several items among color Doppler imaging, CT and MRI.
Ultrasonography could determine the enlarged ophthalmic vein with signal of blood stream and could detect the pulsation synchronizing with the pulse. CT and MRI could display the enlargement and abnormality of cavernous sinus. DSA could reveal fistulas supplied by internal carotid artery directly or by the dual branches of the carotid artery. The latter included meningohypophyseal trunk, capsular artery, middle meningeal artery, accessory meningeal artery, ascending pharyngeal artery and the artery of the foramen rotundum, etc. The drainage pathway of fistula included ophthalmic vein, inferior petrosal sinus, intercavernous sinus, sylvian vein and cortical drainage, etc.
Each method of examination has its own advantages, combining of various methods can lead to an accurate diagnosis of CCF. DSA is the "golden standard" which can display supplying artery and the drainage pathway.
评估超声、CT、MRI及数字减影血管造影（DSA）在诊断颈内动脉海绵窦瘘（CCF）中的价值。
对28例CCF患者行眼科A/B超及DSA检查，部分患者同时行彩色多普勒成像、CT及MRI中的一项或多项检查。
超声可显示眼静脉增粗及血流信号，并可探及与脉搏同步的搏动。CT及MRI可显示海绵窦增大及异常。DSA可直接显示颈内动脉供血的瘘口或颈内动脉双分支供血，后者包括脑膜垂体干、包膜动脉、脑膜中动脉、脑膜副动脉、咽升动脉及圆孔动脉等。瘘口的引流途径包括眼静脉、岩下窦、海绵间窦、大脑侧裂静脉及皮质引流等。
各种检查方法各有优势，多种方法联合应用有助于CCF的准确诊断。DSA是显示供血动脉及引流途径的“金标准”。
