目的探讨三维动态增强MR血管 造影(3D-CE-MRA)在颈动脉海绵窦瘘(CCF) 的诊断价值。方法 回顾性分析10例具有 完整临床和影像学资料的CCF病例，所有 患者均行三维时间飞跃法MR血管造影(3DTOF-MRA)及3D-CE-MRA，其中7例为外伤 性，3例为自发性，男性6例，女性4例， 均经临床及DSA确诊，比较分析3D-TOFMRA与3D-CE-MRA在CCF的显示效果。结果 10例患者中3D-TOF-MRA可见6例显示海绵 窦扩张，9例可见眼上静脉扩张，2例岩上 窦、2例岩下窦引流，海绵间窦扩张2例， 瘘口显示2例；3D-CE-MRA可见全部10例患 侧海绵窦扩大，3例为两侧海绵窦显影并 扩大，可见海绵间窦扩张，眼上静脉扩张 10例，岩上窦引流5例，岩下窦7例，瘘口 显示6例。结论 3D-CE-MRA较3D-TOF-MRA 在CCF诊断对海绵窦扩大及瘘口显示、静 脉回流等细节显示更清楚，但对双侧海绵 窦同时显影时需结合临床及其他征象鉴别。

Objective To discuss the diagnostic value of three-dimensional dynamic contrast-enhanced MR angiography (3D-CE-MRA) in the detection for carotid cavemous fistula (CCF). Methods To retrospectively analyzed 10 cases of CCF which were finally confirmed by DSA or clinical manifestations to compare with the display effect of 3D-TOF-MRA and 3D-CE-MRA in CCF. All of the patients were performed 3D-TOF-MRA and 3D-CE-MRA scan.7 cases of them were caused by trauma, and other 3 cases were Spontaneity. 6 cases were males and 4 cases were females. Results Ten patients of CCF, there were 6 cases found enlarged cavernous sinus, 9 cases found enlarged superior ophthalmic vein, 2 cases found drainage of superior petrosal sinuses and 2 cases of inferior petrosal sinuses, 2 cases found enlarged of cavernous sinus and 2 cases displayed fistula in 3D-CE-MRA, there were 10 cases found enlarged cavernous sinus, 10 cases found enlarged superior ophthalmic vein, 5 cases found drainage of superior petrosal sinuses,7 cases found drainage of inferior petrosal sinuses, 3 cases found enlarged of cavernous sinus and 6 cases displayed fistula in CE-MRA. Conclusion In diagnosis of CCF，3D-CE-MRA is more clear than 3D-TOF-MRA in display enlarged cavernous sinus, venous return and fistula, but when the both cavernous expand at the same time, we need combining with clinical history and other signs to differentiate diagnosis.