硬脑膜动静脉瘘MSCTA诊断的临床价值
|
摘要
目的探讨多层螺旋CT血管造影(MSCTA)在硬脑膜动静脉瘘诊断中的临床价值。方法回顾性分析6例硬脑膜动静脉瘘MSCT影像表现,6例患者均行DSA检查,CTA采用(VR)、最大密度投影法(MIP)等方法进行图像重组,多角度显示脑血管树,观察供血动脉、引流静脉、静脉窦瘘口的情况,与DSA进行对比,观察其一致性。结果本组硬脑膜动静脉瘘2例发生在横窦-乙状窦区(均为Ⅰ型),2例位于海绵窦区(分别为Ⅰ、Ⅱ型),1例位于额叶颅底区(Ⅲ型),1例自两侧顶部引流至上矢状窦(Ⅱ型)。对于引流静脉和静脉窦等细节显示,CTA表现与DSA和手术所见高度一致。结论在硬脑膜动静脉瘘的诊断中,根据其发病部位及分型,以及有无并发症等征象,MSCTA对于临床治疗方案的选择具有重要意义。
Objective To investigate the clinical values of MSCTA in the diagnosis of dural arteriovenous fistula( DAVF).Methods We retrospectively analyzed MSCTA images of 6 patients with DAVF. All of the patients had undergone DSA examination. VR and MIP reconstruction were used during CTA examination,and the feeding artery,draining vein and venous sinus fistula were observed and compared with DSA images. Results 2 cases of DAVF were located in the transversesinus-sigmoid sinus area( Borden Ⅰ),2 cases were located in the cavernous sinus( Borden Ⅰ and Ⅱ),1 case was located in the frontal skull base( Borden Ⅲ),and 1 case was located in the bilateral parietal area( Borden Ⅱ). CTA had high concordance with DSA and surgery in displaying feeding arteryand draining veins. Conclusion MSCTA has great value in the diagnosis of DAVF. It provides guidance for clinical therapy according to the location and classification and the presence of complications.
Objective To investigate the clinical values of MSCTA in the diagnosis of dural arteriovenous fistula( DAVF).Methods We retrospectively analyzed MSCTA images of 6 patients with DAVF. All of the patients had undergone DSA examination. VR and MIP reconstruction were used during CTA examination,and the feeding artery,draining vein and venous sinus fistula were observed and compared with DSA images. Results 2 cases of DAVF were located in the transversesinus-sigmoid sinus area( Borden Ⅰ),2 cases were located in the cavernous sinus( Borden Ⅰ and Ⅱ),1 case was located in the frontal skull base( Borden Ⅲ),and 1 case was located in the bilateral parietal area( Borden Ⅱ). CTA had high concordance with DSA and surgery in displaying feeding arteryand draining veins. Conclusion MSCTA has great value in the diagnosis of DAVF. It provides guidance for clinical therapy according to the location and classification and the presence of complications.
引文
[1]凌锋,伍建伟,张鸿祺,等.硬脑膜动静脉瘘的分型及临床意义[J].中华医学杂志,2001,10(81):1439-1442.
[2] Borden JA,Wu JK,Shucarl WA. A proposed classification forspinal and cranial dural arteriovenous fistulous malformations andimplications for treatment[J]. J Neurosurg,1995,82(2):166-179.
[3] Im SH,Oh CW,Han DH,et al. Surgical management of an un-ruptured dural arteriovenous fistulas of anterior cranial fossa[J].Surg Neurol,2004,62(1):72-75.
[4] Kohama M,Nishimura S,Mion M,et al. Anterior cranial fossadural arteriovenous fistulas with bilateral cranial drainers[J].Neurol Med Chir,2010,50(3):217-220.
[5] Tanei T,Fukui,Wakabayashi K,et al. Dural arteriovenous fis-tulas in the anterior cranial fossa[J]. Neurol Med Chir,2008,48(5):560-563.
[6]田冰,陆建平,许兵,等.硬脑膜动静脉瘘:4DCTA和DSA在诊断与分型中的对照研究[J].影像诊断与介入放射学,2014,1(23):3-6.
[7]赵鹏飞,帕米尔·阿布都卡地,鲜军舫,等.以搏动性耳鸣为首发症状的硬脑膜动静脉瘘的CTA评估[J].中华医学杂志,2013,33(93):2622-2626.
[8]刘作勤.硬脑膜动静脉瘘[J].医学影像学杂志,2002,12(12):469-470.
[2] Borden JA,Wu JK,Shucarl WA. A proposed classification forspinal and cranial dural arteriovenous fistulous malformations andimplications for treatment[J]. J Neurosurg,1995,82(2):166-179.
[3] Im SH,Oh CW,Han DH,et al. Surgical management of an un-ruptured dural arteriovenous fistulas of anterior cranial fossa[J].Surg Neurol,2004,62(1):72-75.
[4] Kohama M,Nishimura S,Mion M,et al. Anterior cranial fossadural arteriovenous fistulas with bilateral cranial drainers[J].Neurol Med Chir,2010,50(3):217-220.
[5] Tanei T,Fukui,Wakabayashi K,et al. Dural arteriovenous fis-tulas in the anterior cranial fossa[J]. Neurol Med Chir,2008,48(5):560-563.
[6]田冰,陆建平,许兵,等.硬脑膜动静脉瘘:4DCTA和DSA在诊断与分型中的对照研究[J].影像诊断与介入放射学,2014,1(23):3-6.
[7]赵鹏飞,帕米尔·阿布都卡地,鲜军舫,等.以搏动性耳鸣为首发症状的硬脑膜动静脉瘘的CTA评估[J].中华医学杂志,2013,33(93):2622-2626.
[8]刘作勤.硬脑膜动静脉瘘[J].医学影像学杂志,2002,12(12):469-470.