脑动静脉畸形的影像与病理比较分析

目的探讨脑动静脉畸形（CAVM）CT、MRI、CTA、MRA、DSA等影像学表现并进行比较分析。方法收集脑动静脉畸形75例，以手术病理及DSA作为诊断的金标准，比较CT、MRI、CTA、MRA、DSA影像学表现，分析各种影像手段的优缺点。结果CT诊断AVM的敏感性为89．3％（67／75），MR诊断AVM的敏感性为96％（72／75）。CT呈团块状、蜂窝状、结节状或条索状；MR呈蚯蚓状或线样无信号流空血管影；CT发现钙化及超早期出血较MR敏感，MR对血肿的分期敏感。CTA、MRA、DSA可见瘤巢、引入动脉影及引流静脉影，CTA、MRA分辨率不及DSA，DSA对AVM内部结构的显示不及CTA、MRA。影像学表现可以反映脑动静脉畸形的大体病理结构。结论不同的影像手段对AVM的诊断各具有价值，结合不同的影像手段完全可以达到诊断定性的目的．影像表现可以反映AVM大体病理的表现。

The Analysis of Imaging of Cerebral Arteriovenous Malformation Combined with Pathology

Objective Seventy-five patients with cerebral arteriovenous malformation were confirmed by CT, MRI, CTA, MRA, DSA and pathology after surgical operation. Results The sensitivity of CT diagnosis valve was 89.3%, and MR was 96%. In the CT, AVM imaging display mass, honeycomb, nodosity, strip, patch and blotch forms. In the MR, imaging display earthworm or line form that had no signal in the vessels. The CT discovery calcify and super-early hemorrhage were more sensitive than MR, and MR was more sensitive in hemorrhage stage. Therefore the CTA, MRA, DSA may find the introduction arterys and drain veins. The resolution of CTA and MRA was lower than DSA, while in internal structure imaging of AVM ,CTA and MRA was super to DSA. The angiography was able to reflect the pathologic construction of arteriovenous malformation. Conclusion The different image means have its value in diagnosis AVM . To combine different image means can completely the diagnosis AVM. the image performance can reflect the pathologic performance of arteriovenous malformation.