Computed orbital phlebography of the cavernous sinuses.

Area of Science:

• Neuroradiology
• Vascular Imaging
• Neuro-oncology

Background:

• The cavernous sinuses are critical venous structures surrounding the pituitary gland.
• Intrasellar and parasellar lesions can affect cavernous sinus anatomy and function.
• Accurate evaluation of cavernous sinus involvement is essential for surgical planning and prognosis.

Purpose of the Study:

• To evaluate the utility of computed orbital phlebography (COP) in assessing cavernous sinus involvement by intrasellar and parasellar lesions.
• To correlate COP findings with the presence and extent of pituitary tumors.

Main Methods:

• Computed orbital phlebography (COP) was performed by injecting contrast medium into a frontal vein.
• The technique was applied to 19 patients with intrasellar or parasellar lesions and two normal controls.
• Findings included bilateral opacification, unilateral partial obliteration, and ipsilateral total obliteration of the cavernous sinus.

Main Results:

• Bilateral cavernous sinus opacification was observed in 12 subjects, with eight having pituitary tumors.
• Unilateral partial obliteration was seen in four subjects with pituitary tumors and parasellar extension.
• Ipsilateral total obliteration of the cavernous sinus occurred in three subjects with parasellar tumors.

Conclusions:

• Computed orbital phlebography is a valuable tool for evaluating cavernous sinus involvement in patients with pituitary and parasellar lesions.
• COP findings correlate with tumor presence and extent, aiding in diagnosis and treatment planning.
• Technical factors can influence the success and interpretation of COP.