颈动脉海绵窦瘘诊治研究.doc

颈动脉海绵窦瘘诊治研究【摘要】目的探讨颈动脉海绵窦瘘(CCF)的临床特点、影像学诊断价值和介入治疗的效果。方法回顾性分析13例CCF患者的临床表现、影像学特点及介入治疗情况。结果13例患者的临床表现均以眼科症状为主，分别行B超、CT或MRI检查时发现，其中12例行数字减影血管造影(DSA)确诊并以介入治疗。12例患者介入治疗后瘘口完全闭塞，临床症状和体征不同程度的改善。结论特征性眼部表现结合眼部B超、CT、MRI等影像学检查可确诊CCF。DSA检查及介入治疗仍是目前最理想的诊断和治疗方法。 【关键词】颈动脉海绵窦瘘；影像学检查；数字减影血管造影；介入治疗 Analysis of diagnosis and treatment of carotid cavernous fistulaPAN Xiaohui, ZHANG Jiacheng, GUO Fei Department of Ophthalmology, Kunhua Affiliated Hospital of Kunming Medical College, First Peoples Hospital of Yunnan Province, Kunming, Yunnan,650032,PRChina 【Abstract】ObjectiveTo investigate the clinical features, the value of imaging diagnosis and interventional therapy of carotid cavernous fistula(CCF) MethodsThe clinical manifestations, imaging features and interventional therapy of 13 cases of patients with CCF were retrospectively analyzed ResultsOcular signs and symptoms are the main clinical manifestations of CCF13 cases underwent Bultrasonography, Multislice spiral CT or MRI scan, 12 cases were confirmed by Digital subtraction angiography (DSA)Treated by interventional therapy, the fistula disappeared, clinical symptoms and signs of CCF were improved ConclusionCharacteristic ocular findings and imaging features of Bultrasonography, Multislice spiral CT or MRI scan can confirm the diagnosis of CCF DSA and interventional therapy is still the ideal method of diagnosis as well as treatment of CCF. 【Key words】Carotid cavernous fistula; Imaging examination; Digital subtraction angiography; Interventional therapy 作者单位：650032昆明医学院附属昆华医院/云南省第一人民医院眼科 (潘晓辉)，介入科(张家成)，放射科(郭飞) 通讯作者：潘晓辉Email:huihuang915@hotmailcom颈动脉海绵窦瘘(carotid cavernous fistula, CCF)是由于外伤或血管病变引起的颈内动脉海绵窦段本身及其分支或颈外动脉脑膜支与海绵窦之间形成的异常动静脉沟通所致的一组神经眼科综合征［1,2］。据报道80%以上的患者因眼部症状而首诊于眼科，因此易被眼科医生误诊误治。现对本院2006年6月至2010年11月收治的13例CCF患者的临床资料进行回顾性分析，报告如下。 1资料与方法 11一般资料本组病例共13例，男性8例，女性5例；年龄38～76岁，平均435岁；左侧发病7例，右侧发病6例；外伤性病例9例，其中车祸伤5例，摔伤2例，拳击伤2例；自发性病例4例，均有高血压病史，其中1例合并糖尿病病史，1例并发冠心病，心律失常及多发腔隙性脑梗死；入院时除1例血压较高(160/100 mm