大脑大静脉畸形的影像学诊断

目的探讨大脑大静脉畸形的影像学诊断价值。资料与方法回顾性分析4例经证实为大脑大静脉畸形的CT、MRI、MRA及DSA的影像学表现。结果4例均显示有大脑大静脉瘤样扩张,瘤巢形成伴周围引流小静脉增多。其中1例表现为天幕动脉瘘入大脑大静脉并动脉瘤形成伴直窦血栓,另3例表现为中线旁区的动静脉畸形引起大脑大静脉瘤样扩张。结论多种影像学检查方法的结合应用对大脑大静脉血管畸形的准确诊断有重要价值。     

动脉瘤样骨囊肿1例报告

动脉瘤样骨囊肿为一种少见的良性骨病。现将我院遇到的１例报告如下。患者女，２８岁。１年前自觉右肘钝疼，去当地医院就诊，行Ｘ线拍片检查诊断为右尺骨近端慢性骨感染，经长期抗炎治疗无效前来我院就诊。查体。右尺骨鹰嘴后方表皮稍红肿，轻压痛，但肘关节屈伸功能尚正...     

肩胛骨动脉瘤样骨囊肿1例报告

病例介绍 :女 ,3 4岁 ,因左肩胛骨肿痛反复发作 11个月 ,始时较轻 ,而后逐渐加重而于我院就诊。体查 :左肩关节肿胀 ,左肩关节活动轻度受限。实验室检查 :无特殊。Ｘ线检查 :摄左肩关节正位及穿胸位照片示 ,左肩胛骨关节盂下部可见 2 .5ｃｍ× 2ｃｍ大小的囊性占位病灶 ,偏心性生长 ,其内可见分隔 ,内侧缘有一波浪状骨质硬化边与正常骨组织分界清楚 ,下缘骨皮质膨胀 ,并见部分破坏缺损改变。Ｘ线诊断 :左肩胛骨占位性病变 ,考虑为良性骨肿瘤可能性大 ,骨巨细胞瘤 ?骨囊肿 ?ＣＴ检查 :左肩胛骨关节盂下部可见一多房囊性骨质改变 ,呈膨胀性生…     

骶骨动脉瘤样骨囊肿1例报告

病人,女,２０岁。右骶部疼痛性包块伴鞍区麻木３个月。３个月前无诱因感骶部隐痛,右侧骶部隆起,渐出现二便障碍。体检：鞍区浅、深感觉减退,四肢肌力Ⅴ级,右骶部触及肿块大小约５ｃｍ×５ｃｍ,质硬、固定,压之疼痛及鞍区麻木加重。Ｂ超检查：子宫右后方探及６．９ｃｍ×４．０ｃｍ大小低回声包块,边缘清楚,内部回声均匀。Ｘ线检查：骶３～５右侧骨质膨胀性破坏,边缘清楚,无明显硬化（图１）。ＣＴ检查：骶骨右侧明显骨质破坏,可见约６．５ｃｍ×５．６ｃｍ大小的巨大软组织块,分叶状,境界清楚,密度不均匀,ＣＴ值２２～６４…     

颅骨动脉瘤样骨囊肿1例报告

颅骨动脉瘤样骨囊肿１例报告湖南怀化市人民医院放射科潘荣贵颅骨动脉瘤样骨囊肿少见，笔者遇见一例报告如下：女性，２８岁，左额前发际处局限性骨性凸起约一年，偶头痛，梳理触摸时有痛感而就医，无其它全身不适。Ｘ线检查：颅骨正侧位示额顶稍偏左见一局限性骨质破坏区...     

跖骨动脉瘤样骨囊肿1例报告

骨动脉瘤样骨囊肿是一种少见的良性肿瘤样病变,笔者遇到1例,现报道如下。患者女,34岁。1年前无明显诱因出现左足背部时有肿胀,轻度疼痛,休息后可缓解,活动后加重。半年前活动后左足出现跛行。半月前疼痛症状明显加重,足背部肿胀不退,于当地医院拍片发现左足第3跖骨溶骨性破坏。CT示第3跖骨呈膨胀性骨质破坏(图1,2)。患者自发病以来无发热、盗汗、心慌气短等症状。查体:左足背肿胀,可触及肿块,有压痛,无波动感,局部皮温不高,表浅静脉怒张,足背动脉搏动可触及。术中所见:第3跖骨破坏,自跖骨头至中后部,长约6cm,肿瘤未突破入软组织,骨皮质不完…     

大脑内静脉性血管畸形1例报告

脑静脉性血管畸形相当少见 ,而大脑内静脉性血管畸形更被临床上视为罕见的血管畸形。我院遇到 1例 ,现报道如下。患者　男 ,3 1岁 ,头痛、呕吐、意识模糊 1ｄ。代述患者于发病前两天开始轻微头痛 ,于前一日晚突然跌倒 ,头痛剧烈 ,呕吐1次 ,为胃内容物 ,呈非喷射状 ,继而出现意识模糊、烦躁。查体 :Ｔ 3 6℃ ,Ｐ 84次 /ｍｉｎ ,Ｒ 2 2次 /ｍｉｎ ,Ｂｐ 2 0 /14ｋＰａ ,神志呈浅昏迷状态 ,双侧瞳孔等大等圆 ,对光反射存在 ,颈抵抗明显 ,心、肺腹部无异常。专科检查 :双上肢肌力、肌张力正常 ,上肢深反射 ( ) ,双侧对称。双下肢肌张力明显增…     

大脑后动脉假性动脉瘤栓塞治疗1例报告

大脑后动脉假性动脉瘤临床上非常少见,其病理学特点表现为多种原因造成动脉破裂出血形成血肿,血肿吸收后残留假腔所致。由于缺乏真正的动脉瘤壁结构,极易破裂出血,其死亡率及病残率较高。对此病做出早期诊断并选择正确的治疗方案对于挽救患者生命是非常重要的。我们于2004年6月收治1例,结合病史、头颅MRA和全脑数字减影血管成像(DSA)证实为左侧大脑后动脉P1段假性动脉瘤,经小片段蓝宝石可脱卸弹簧圈(SDC)栓塞术后治愈出院。     

Galen静脉瘤1例报告

Ｇａｌｅｎ静脉瘤也称大脑大静脉瘤 ,临床本病很少见 ,约占颅内血管畸形的 1%～ 5 % [1] 。我们遇见 1例报告如下。患儿　女 ,8个月。近 1月来食欲不振 ,烦躁不安 ,嗜睡伴左侧眼球突出。检查 :左上眼睑肿胀 ,左眼球活动障碍 ,但对光反射存在 ;双膝腱反射减弱。ＣＴ检查 :平扫示三脑室后大脑大静脉池内 4ｃｍ× 3.5ｃｍ大小的类圆形稍高密度影 ,ＣＴ值 35 .7ＨＵ ,边缘光滑境界清楚 ;第三脑室前部及双侧脑室对称性明显扩大。增强扫描病灶呈明显均匀强化 ,横窦、直窦及上矢状窦均有不同程度扩张 (图1,2 )。讨论 :Ｇａｌｅｎ静脉瘤因为具有动脉…     

Occlusion of Posterior Fossa Dural Sinuses in Vein of Galen Malformation

BACKGROUND AND PURPOSE:Spontaneous or progressive occlusion of the posterior fossa dural sinuses is often observed in patients with vein of Galen malformation, which can affect the clinical course. The aim of this study was to examine the patency of the posterior fossa dural sinuses in patients with vein of Galen malformation and to analyze the clinical and angiographic course of this condition.MATERIALS AND METHODS:We retrospectively reviewed 61 consecutive children with vein of Galen malformations. Clinical presentation, management, outcome, and angiographic change were analyzed for the patients with attention paid to all dural sinus occlusions.RESULTS:Twenty patients (32.8%) demonstrated spontaneous sinus occlusion, mostly in the sigmoid sinus. This condition was not observed in neonates and was first discovered during infancy or childhood. Progression of sinus occlusion was seen in 10 patients, and the conditions of 6 of them deteriorated in accordance with the progression of sinus occlusion. After total or subtotal obliteration of the malformation by transarterial glue embolization, 13 patients recovered to healthy, 3 patients had only mild developmental delay, and 4 patients remained neurologically disabled.CONCLUSIONS:Spontaneous sinus occlusion is not a rare condition and can result in neurologic deterioration in the natural history of untreated vein of Galen malformation. If signs of progressive sinus occlusion are noticed, early arteriovenous shunt reduction or elimination by transarterial glue embolization is expected to prevent permanent brain damage.

Vein of Galen malformations (VGMs) are direct arteriovenous shunts in the subarachnoid space of the velum interpositum cistern and quadrigeminal cistern, supplied by the choroidal and quadrigeminal arteries and drained by the dilated median prosencephalic vein of Markowski, the embryonic precursor of the vein of Galen.^1,2 This malformation is considered to form between 6 and 11 weeks of gestational age when this transient embryonic vein exists.The clinical presentation of VGM varies depending on the age of the patient. Neonates typically present with high-output congestive heart failure due to high-flow shunt producing cardiac overload, whereas infants and children usually present with hydrovenous disorders, such as macrocrania, prominent facial and scalp veins, and hydrocephalus.^2,3 Hydrovenous disorders result from diminished absorption of CSF due to cerebral venous hypertension.⁴ Development of outflow restriction in the posterior fossa dural sinuses will improve the cardiac overload but will lead to further intracranial venous hypertension, which will not only interfere with absorption of CSF but will also create congestion within cerebral veins. Venous hypertension consequently results in brain tissue loss and hence developmental delay.^2,3Thus, posterior fossa dural sinus occlusion is thought to aggravate the clinical course of VGM. However, its incidence, pathogenic mechanism, and the effect of endovascular embolization are unknown. The aim of this study was to analyze the clinical and angiographic course of patients with VGM with sinus occlusion and to determine whether embolization can prevent clinical deterioration in these patients.     

大脑大静脉瘤样畸形的诊断和介入治疗

报告６例Ｇａｌｅｎ大脑大静脉瘤样畸形的诊断及介入治疗。６例患者分二型：Ⅰ型真正的大脑大静脉瘤样畸形２例，以新生儿、婴幼儿多见。Ⅱ型：Ｇａｌｅｎ静脉附近脑实质和硬膜的血管畸形，静脉引流远端狭窄，继发引起Ｇａｌｅｎ静脉扩张４例，以儿童及成年人多见。应用栓塞治疗使Ⅰ型获得痊愈，Ⅱ型可明显改善临床症状。     

冠状动脉畸形1例报告

患者　男,69岁。主因阵发性心前区疼痛半年余,加重2月,以“不稳定性心绞痛”收住院。入院后查心电图示:窦性心律,慢性冠状动脉供血不足。超声心动图示:主动脉硬化,室壁肥厚,左室舒张功能减低,LVEF 66%。入院后行冠状动脉造影,常规以6FJL4造影管行左冠脉造影时,导管不能进入左冠     

肾动静脉畸形1例

患者男,48岁,不明原因肉眼血尿1周入院,查体无阳性体征.     

腹膜后血管畸形1例报告

患者男,28岁。1个月前自觉右上腹胀满不适,并于右侧腹部可触及约拳头大小之肿物,站立时肿物触及较明显,同时伴有压痛而来院就诊。检查:右上腹部可触及12 cm×10 cm×11 cm大小肿物,质中等光滑,边界尚清晰,活动度可,肿物按CT检查:肝左叶肝内胆管轻度扩张,于肝脏下方内侧可见13 cm×11 cm×16 cm大小不规则的囊状低密度,边界清晰,密度均匀,CT值23.99 HU,部分层面病变呈多房状改变(图1)。增强扫描病变内无明显强化,仅显示部分增厚的囊壁强化(图2)。冠状重建显示病变位于肝脏及胃窦内下方,呈囊状低密度(图3)。CT诊断:肝脏内侧前下方腹膜后囊…     

Transarterial Embolization with Berenstein Liquid Coils and N-butyl Cyanoacrylate in a Vein of Galen Aneurysmal Malformation: a Case Report

A 12-week-old baby with a vein of Galen aneurysmal malformation (VGAM) was successfully treated with performing transarterial microcatheter-directed embolization with Berenstein Liquid Coils and n-butyl cyanoacrylate in the feeding arteries. Post-procedure angiography showed a marked decrease of the blood flow into the dilated vein of Galen. Three months later, follow-up angiography showed that the vein of Galen aneurysmal malformation had totally disappeared, and the baby recovered very well without any sequelae. We report here on this interesting case along with a review of the relevant literature, and we aim to enhance physicians'' awareness of the treatment for VGAMs.     

肺多灶性动静脉畸形1例报告

肺动静脉畸形(pulmonaryarteriovenousmalformation ,PAVM )又称肺动静脉瘘,是一种少见的发育畸形。肺多灶性动静脉畸形更为罕见。笔者遇到1例报告如下。患者,女,43岁。主因咳嗽、气短10年,近日加重。查体:口唇紫绀,双手杵状指,心肺听诊无异常。X线平片表现:正位片右肺下野内带     

纵隔混合型脉管畸形1例报告

患者　男,40岁。2 0年前无明显诱因出现咯血,有时痰中带血,鲜红色。曾诊断肺结核,抗结核治疗无明显效果。近十余年,病情反复并有加重,外院多次CT误诊为肺癌。影像学表现:X线平片,1985年正位X线胸片示右下肺门区高密度影,呈长椭圆形,边缘不清(图1)。1996年右肺门区及心缘旁肿块明显增大(图2 )。2 0 0 3年X线片与1996年X线表现变化不明显。CT检查:右下纵隔内见一不规则形软组织密度肿块,密度不均,其内侧缘与心脏、下腔静脉紧密相连,右缘光滑锐利。右下叶后段肺叶实变,密度不均,内有含气支气管。增强扫描纵隔内不规则肿块无强化,肺实变影内…     

先天性肺囊性腺瘤样畸形1例报告

男,3岁8个月,因发现胸骨凹陷3年半,易感冒近1年就诊。无发热、活动后气促及心悸。体检:胸骨凹陷明显,以剑突为甚,胸廓前后径变短,心界右移,听诊无杂音,左肺呼吸音稍低。诊断为先天性漏斗胸行术前检查时发现左肺囊性病变。胸部平片表现为左肺下叶多发大小不等的圆形薄壁含气囊性