Imaging of the Cavernous Sinus

摘要

Because of the complicated anatomy and presence of multiple cranial nerves and vessels, cavernous sinus lesions present with complex signs and symptoms, making precise localization of a lesion difficult without imaging. MR imaging is the modality of choice for detecting and characterizing cavernous sinus lesions. Some cavernous sinus lesions, such as aneurysms and thrombosis, may have such distinct imaging appearances that the diagnosis is confirmed. Other lesions, such as lymphoma, Tolosa-Hunt, and metastases to the cavernous sinus, can only be suggested based on imaging. Adequate MR imaging of the cavernous sinus often requires high-resolution multiplanar sequences, and the use of gadolinium-based contrast agents is helpful. Thus, the neurosurgeon should communicate with the radiologist that a cavernous sinus lesion is suspected, so that the study can be tailored to evaluate best the central skull base and the cavernous sinus. Common lesions of the cavernous sinus are discussed, with illustrative images. The emphasis on MR images reflects the importance of this modality in evaluating the cavernous sinus.