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目的探讨海绵窦型硬脑膜动静脉瘘的最佳检查与治疗方法。方法对比分析34例该病患者各种检查及血管内栓塞治疗的结果。结果CT检查阳性9例;MRI、MRA检查阳性表现23例;3D-TCD检查有24例表现患侧眼静脉流速升高;DSA检查可以清楚地反应海绵窦型硬脑膜动静脉瘘的全貌。34例患者有17例获解剖学治愈,4例临床治愈,10例好转,1例出现偏瘫,2例未治。结论DSA是确诊海绵窦型硬脑膜动静脉瘘的金标准,能显示出瘘口的类型、血供及静脉引流方式;CT、MRI、MRA及3D-TCD只能反应部分颅内继发性改变。血管内栓塞是目前治疗海绵窦型硬脑膜动静脉瘘唯一安全有效的方法。
Objective To explore the best examination and treatment of cavernous sinus dural arteriovenous fistula. Methods The results of various examinations and endovascular embolization in 34 patients were compared and analyzed. Results CT was positive in 9 cases, MRI and MRA were positive in 23 cases, and in 24 cases in 3D-TCD, the flow velocity of ophthalmic vein in the affected side was increased. DSA could clearly reflect the whole picture of cavernous sinus dural arteriovenous fistula. Of the 34 patients, 17 were cured by anatomy, 4 were clinically cured, 10 were improved, 1 was hemiplegia, and 2 was untreated. Conclusion DSA is the gold standard for the diagnosis of cavernous sinus dural arteriovenous fistula. It can show the type of fistula, blood supply and venous drainage. CT, MRI, MRA and 3D-TCD can only respond to some intracranial secondary changes . Endovascular embolization is the only safe and effective method for the treatment of cavernous sinus dural arteriovenous fistula.