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CT angiography diagnosis on the rupture of traumatic pseudoaneurysms of the cavernous of the internal carotid artery into the sphenoid sinus

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF RADIOLOGY
Issue:
6
DOI:
10.3760/cma.j.issn.1005-1201.2011.06.012
Key Word:
动脉瘤,假性;颈动脉疾病;体层摄影术,X线计算机;血管造影术;蝶窦;Aneurysm,false;Carotid artery diseases;Tomography,X-ray computed;Angiography;Sphenoid sinus

Abstract: Objective To investigate diagnostic value of CTA for traumatic pseudoaneurysms (TPA) in the cavernous segment of the internal carotid artery (ICA) when they rupture into the sphenoid sinus. Methods CTA of 7 patients with TPA in the cavernous segments of ICA verified by DSA were retrospectively analyzed. All the patients were performed CTA scanning. The post-processing techniques included VR,MIP,MPR, and CPR. Results All the CTA images of 7 patients showed irregular mass in the sphenoid sinus with obviously enhancement in the same phase to ICA, which communicating with ICA in wide base. The peripheral area of the mass showed no enhancement. The size varied from 3 mm × 2 mm × 1 mm to 33 mm × 30 mm × 27 mm. The adjacent lateral wall of sphenoid sinus showed fractures in all cases. TPA located at anterior-knee segments of cavernous ICA in 6 cases, and cavernous free segment in 1 case. All the disruptions were found at medial or anterior medial wall of ICA. Conclusions Cranial CTA is the effective non-invasive method for diagnosing TPA in the cavernous segment of ICA when they rupture into sphenoid sinus. Combined using of VR, MIP, MPR, and CPR can delineate the location and size of the sphenoid wall fracture and the ICA rupture, which help to clarify the anatomical relationship between them.

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