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目的 探讨数字减影血管造影对颈动脉海绵窦瘘诊断的价值 ,并通过对其血管造影表现的分析 ,指导栓塞治疗。方法 12 6例颈动脉海绵窦瘘进行DSA检查 ,每例患者均行超选择颈内、外动脉造影 ,同时将本组病例分为 4类。结果 12 6例颈动脉海绵窦瘘中 ,A型瘘 88例 ;B型瘘 11例 ;C型瘘 2 3例 ;D型瘘 12例。 88例直接瘘造影确定瘘口位置 ,瘘口位于颈内动脉海绵窦Ⅰ段 5例 ;Ⅱ段 2 9例 ;Ⅲ段 11例 ;Ⅳ段 34例 ;Ⅴ段 9例。根据DSA表现 ,10 2例采用经股动脉途径栓塞 ,2 2例经眼上静脉途径。结论 数字减影血管造影可较好地显示颈动脉海绵窦瘘的位置和大小 ,同时 ,可以有效地评价Willis环功能 ,为其栓塞治疗提供有价值的信息。在CCF的治疗中可脱性球囊栓塞是最理想的首选方法。
Objective To explore the value of digital subtraction angiography in the diagnosis of carotid cavernous fistula, and to guide the embolization by analyzing its angiographic findings. Methods Twenty - six cases of carotid cavernous fistula were examined by DSA. Each case underwent superselective internal carotid and external arterial angiography. At the same time, the patients were divided into four groups. Results 12 cases of carotid cavernous fistula, 88 cases of type A fistula, 11 cases of type B fistula, 23 cases of type C fistula, 12 cases of type D fistula. 88 cases of direct fistula angiography to determine the location of fistula, fistula located in carotid artery Ⅰ section of cavernous 5 cases; Ⅱ section 29 cases; Ⅲ section 11 cases; Ⅳ section 34 cases; Ⅴ section 9 cases. According to DSA, 102 cases were treated with femoral artery embolization and 22 cases with ophthalmic vein. Conclusions Digital subtraction angiography can show the position and size of carotid cavernous fistula well, at the same time, evaluate the function of Willis ring effectively and provide valuable information for its embolization treatment. In the treatment of CCF detachable balloon embolization is the best method of choice.