Imaging Diagnosis Of Cavernous Sinus Cavernous Hemangioma

BackgroundCavernous sinus cavernous hemangioma(CSHAs) is the cavernous abnormal blood vessels wich is composed of many thin-walled vascular,Its incidence is less than 2% of the cavernous sinus region tumors.It is always been the key points of neurosurgery because its incidence is very low, atypical symptoms and signs, around the complex anatomy and it has many surgical complications.Now surgical treatment is preferred, There are also radiation therapy and stereotactic radiotherapy,wich is suitable for different cases, neurosurgeon needed depending on the patient’s symptoms, pre-operative imaging data and physical condition a reasonable selection of individualized treatment programs, so for cavernous sinus disease especially CSHAs, accurate diagnosis and differential diagnosis is particularly important. CSHAs relied heavily on clinical diagnosis of MRI Imaging. Its incidence is very low, and it has no typical symptoms and signs, its image features has many similarities with the other lesions of the cavernous sinus region, CSHAs has high rate of misdiagnosis. Objective:Retrospective analysis the complete case information of the 122 cases of patients with cavernous sinus disease which was treated in our hospital in 15 years,combined with clinical symptoms, signs and pathological findings, analysis of sponge the imaging characteristics of many common, through comparative analysis with other diseases in the region,and summarize the characteristic imaging findings of of CSHAs, to improve the diagnosis and differential diagnosis of CSHAs, Provide references for CSHAs treatment as chosing surgery or radiation therapy, and the choice of surgical or radiotherapy dosage. Methods:This study collected the clinical data of the 122 cases of patients with cavernous sinus disease wich was treated in our hospital from October 2000 to October 2015. Into the standard set: 1. lesion located near CS or CS, fossa, saddle the district before and after around 2. patients had complete information; 3. patients with MRI examination; 4. patients had surgery and have clear results. Exclusion criteria: 1. patients with intracranial space occupying lesions, 2. patients with a history of traumatic or spontaneous intracerebral hemorrhage after cerebral hemorrhage 3. patients with a history of cerebral infarction; 4. patients have a history of intracranial surgery, 5. cranial radiotherapy for patients with history of 6. patient has chemotherapy.Imaging: All patients underwent 3.0TMRI inspection, head of orthogonal coil, Conventional sequences. Plain normal sagittal, axial, coronal T1 WI and T2 WI Imaging; T1 WI was enhanced scanning. Contrast agents is gadopentetic acid dimeglumine salt injection, Amount of 0.2ml/kg. If necessary, plus sweep the MRS and DWI sequence. Some patients with CT or DSA examination. Radiological signs are divided into 12 index: T1 WI,T2WI, T1 signal uniformity, T2 signal uniformity, T1 enhancement sequence, peripheral edema, dural tail sign, shape, violations of sellar region, posterior cranial fossa, subdural or extracranial, respectively readed by two neurosurgeons before they know the pathological diagnosis. If the two doctors have different opinions, organization sections doctors discuss and achieve consensus.Statistical analysis: 122 patients were divided into CSHAs group(20 cases) and non-CSHAs Group(102) based on pathological diagnosis, The latter can be divided into: Schwannoma(31 cases), Meningioma(35 cases), pituitary tumors(25 cases) and others(11 cases).We analysis the 12 imaging characteristics with univariate chi-square analysis,which is based on SPSS19.0 software, P<0.0 1 said there was significant statistical significance.Then we calculate its specificity, sensitivity and precision. Results1.T2 WI signal is very high and uniform, the tumor is like " Horizontal gourds" and broke into the sellar region for the diagnosis of cavernous sinus cavernous hemangioma is statistically significant.Diagnose CSHAs with these four characteristics, sensitivity are 95%、100%、100% and 90%,specificity are 78.4%、65.7%、55.9% and 62.7%, accuracy are 81.1%、71.3%、63.1%、67.2%.2. T2 WI signal is very high and uniform, the tumor is like " Horizontal gourds",broke into the sellar region and dural tail sign for the differential diagnosis of CSHAs and the meningioma of CS is statistically significant. T1 WI and T2 WI uniform signal, T1 WI significantly enhanced, the tumor is like " Horizontal gourds",broke into the sellar region and posterior cranial fossa for the differential diagnosis of CSHAs and the nerve sheath tumors of CS is statistically significant. T2 WI signal is very high and uniform, the tumor is like " Horizontal gourds" for the differential diagnosis of CSHAs and the pituitary tumors is statistically significant. Conclusions:It is support CSHAs diagnosis when the MRI shows that:T2WI signal is very high and uniform, the tumor is like " Horizontal gourds" and broke into the sellar region.