另一篇Magnetic resonance imaging of carotid artery abnormalities in patients with sphenoid sinusitis
Abstract Sphenoid sinusitis is unusual in children, but when it occurs,it can lead to serious intracranial complications. We show the value of MRI in demonstrating intracranial abnormalities due to sphenoid sinus infection, particularly those involving the internal carotid arteries and cavernous sinuses. We reviewed our imaging experience of sphenoid sinusitis and found four patients with ICA narrowing who had undergone MR evaluation including conventional and diffusion imaging. MR angiography was also performed in three patients to determine the extent of ICA narrowing. Narrowing of ICA was found in the cavernous segment in all patients and in the supraclinoid segment in three. Cerebral infarction was found in two patients. In one patient the cavernous sinus showed hyperintensity on diffusion-weighted images and hypointensity on apparent diffusion
coefficient map, suggesting reduced diffusion. Although infrequent in children, sphenoid sinus infection should be considered as a possible cause of intracranial infection, particularly in teenagers. Early recognition of cavernous sinus involvement and ICA narrowing may lead to prompt treatment and hence a more favorable outcome.
Fig. 1 Patient 1. a, b Axial T1- (TR/TE 650/14) and T2-weighted images (6000/99) show narrowing (arrows) of both cavernous ICAs, to a greater extent on the left. Isointensities (arrowhead) on T1WI and mixed signal intensities (arrowhead) on T2WI are noted in the cavernous sinuses. Increased signal in the sphenoid and ethmoid sinuses is compatible with inflammatory disease. c Axial contrastenhanced T1-weighted image (800/20) shows heterogeneous enhancement and expansion (arrows) of the cavernous sinuses. d, e Axial diffusion-weighted image (4000/110, B=1000) and apparent diffusion coefficient map show hyperintensities (arrows) and hypointensities (arrowheads), respectively, in the cavernous sinuses adjacent to both cavernous ICAs. This indicates reduced water diffusion which could be due to thrombus or purulent material
Fig. 2 Patient 2. a Coronal contrast-enhanced T1-weighted image (800/20) shows narrowing of cavernous and supraclinoid
portions of the right ICA. A focal signal void (arrow), indicative of gas, is noted in the right cavernous sinus. b Coronal oblique MRA (TR/TE 35/ 7.2, flip angle 20) shows irregular narrowing (arrows) of cavernous and supraclinoid portions of the right ICA
Fig. 3 Patient 3. a Coronal MRA (35/7.2, flip angle 20) shows loss of signal in both cavernous ICAs (arrows). Severe irregular narrowing (arrowheads) is also seen at the left supraclinoid ICA, bilateral anterior cerebral arteries (ACAs) and middle cerebral arteries (MCAs). b, c Axial diffusion-weighted images (4000/110, B=1000) show hyperintensities (arrows) in the right hypothalamus and in cortical and subcortical areas in the right MCA territory, indicating acute cerebral ischemia/infarction.
d Two months later coronal MRA (35/7.2, flip angle 20 shows severe narrowing (arrows) of proximal right ACA, proximal right MCA, and the right supraclinoid ICA. Reduced flow (arrowheads) in the right ICA and right MCA branches is also noted. The left ICA, ACA, and MCA, previously showing irregular narrowing, are smooth in contour and prominent in size, indicating a complete recovery from arteritis
另一篇分析了151例海绵窦综合征的病因，其中感染病原菌有一半是霉菌
另一篇分析了感染性海绵窦血栓，其中糖尿病患者为55.6%，病原菌55.6%为霉菌
编辑：蓝色幻想
