海绵窦内海绵状血管瘤的影像学诊断(附4例报告)

目的:探讨海绵窦海绵状血管瘤影像学特点,以提高其诊断水平。方法:回顾性分析经手术后病理证实的4例海绵窦海绵状血管瘤,均有CT和MRI检查资料,1例行DSA检查。结果:4例海绵窦海绵状血管瘤均位于左侧,CT表现为均匀的稍高密度影,伴蝶骨轻度骨质侵蚀,未见钙化。MRI检查见T1WI呈较脑灰质低的均匀信号,T2WI呈较脑灰质高的均匀信号,静脉注射钆喷酸葡甲胺后T1WI显示明显强化的均匀高信号,形态特点呈内小外大的哑铃状结构,边缘清晰。1例DSA检查见颈内动脉受压移位明显,但无管腔狭窄征象,于毛细血管期和窦期有浅淡的肿瘤染色。结论:MRI是术前诊断海绵窦海绵状血管瘤最具价值的检查手段,而CT、DSA可作为鉴别诊断工具。

Imaging Diagnosis of Cavernous Hemangioma in Cavernous Sinus (a Report of 4 Cases)

Objective:To investigate the imaging features of cavernous hemangiomas in cavernous sinus and thus to promote the diagnostic ability of the disorder.Methods:A retrospective analysis of 4 cases of cavernous hemangioma in car- vernous sinus,proved surgically and pathologically,was studied.CT and MRI examinations were undergone in all cases,and DSA had also been performed.Results:All of the 4 cases were situated at left cavernous sinus.Mildly and homogeneously hyperdense lesions,accompanying with considerable bony erosion of the sphenoid and no calcification,were found on CT.MRI studies revealed that the signal intensity of the cavernous hemangiomas was homogeneous and lower than that of the gray matter on T_1WI,while slightly higher and homogeneous than that of the gray matter on T_2WI.On MR enhancing scans with Gd-DTPA and T_1WI,the lesions demonstrated homogeneously and highly enhanced.Configuration features of the lesions were dumbbell-like in shape,with sharp outlines and smaller medial portion and larger lateral compartment.DSA examination in one case showed remarkable shift of the ICA,however,no lumen stenosis of the vessel was noted.Mild tumor stain of the hemangioma was found in capillary and venous phases.Conclusion:MRI was the best and most valuable pre-operative imaging examination modality of the disease,and both CT and DSA were helpful diagnostic imaging means for differential diagnosis in equivocal cases.