Palestro C J, Malat J, Gladstone A G, Richman A H
Clin Nucl Med. 1986 Sep;11(9):636-9. doi: 10.1097/00003072-198609000-00010.
Septic cavernous sinus thrombosis, a relatively uncommon disease entity, frequently can be fatal. Early diagnosis is imperative in order that appropriate treatment be instituted. A 59-year-old woman who was admitted to our institution with complaints of diplopia, blurred vision and fevers that developed following a tooth extraction is presented. Initial CT and lumbar puncture on the day of admission were totally normal. A repeat CT performed 48 hours after admission, on the same day as gallium imaging, demonstrated findings consistent with cavernous sinus thrombosis. Gallium imaging demonstrated intense uptake in the left cavernous sinus and left orbit as well as moderately increased activity in the right cavernous sinus and orbit, confirming infection. The patient was treated with antibiotics, and repeat CT and gallium imaging were performed ten days later, both of which demonstrated near total resolution of the disease process. Conceivably, if gallium imaging had been initiated on the day of admission it may have been the first study to demonstrate an infectious process in the cavernous sinus. Gallium imaging should be considered as a diagnostic tool in the noninvasive workup of this entity.
化脓性海绵窦血栓形成是一种相对罕见的疾病，常常可致命。早期诊断至关重要，以便开展恰当治疗。本文介绍了一名59岁女性，因拔牙后出现复视、视力模糊和发热而入住我院。入院当天的初次CT和腰椎穿刺结果完全正常。入院48小时后，即在与镓显像同一天进行的重复CT检查显示出与海绵窦血栓形成相符的表现。镓显像显示左侧海绵窦和左侧眼眶摄取强烈，右侧海绵窦和眼眶活性中度增加，证实存在感染。患者接受了抗生素治疗，十天后进行了重复CT和镓显像，两者均显示疾病进程几乎完全消退。可以想象，如果入院当天就开始进行镓显像，它可能会是首个显示海绵窦存在感染性病变的检查。镓显像应被视为该疾病无创检查中的一种诊断工具。
