脊髓髓内动静脉畸形的血管内介入诊疗

目的：探讨脊髓髓内动静脉畸形行血管内介入的诊疗价值。方法：回顾性分析26例髓内动静脉畸形的选择性动脉造影与栓塞治疗资料，所有患者均行全脊髓动脉数字减影血管造影检查。结果：26例髓内动静脉畸形经血管造影检查，表现为隐匿性髓内血管畸形者6例，余20均能显示病变的范围、血供情况及其特征，其中供血动脉为单纯脊髓前动脉者10例，单纯脊髓后动脉者4例，脊髓前动脉和后动脉同时供血者6例。12例接受了栓塞治疗，达到临床治愈者3例，显效4例，有效3例，无效2例，显效率为58．3％。所有栓塞病例均无严重并发症发生。结论：经选择性血管造影确诊后行栓塞治疗是髓内动静脉畸形安全有效的治疗手段。

Angiographic Diagnosis and Embolization Treatment for Intramedullary Arterio-venous Malformation

Objective: To investigate the value of angiographic diagnosis and the embolization of intramedullary arteriovenous malformation(AVM). Methods:Twenty-six patients with intramedullary AVM underwent selective angiography and embolization were reviewed retrospectively. Using Seldinger technique, angiography of each pair of intercostals, lumbar arteries bilateral vertebral arteries, bilateral thyrocervical and costocervical trunks were performed.Results: Of the 26 patients who underwent selective angiography of intramedullary AVM, 6 of them were diagnosed as occult intramedullary arteriovenous malformation. The extent of lesion, the amount of vascularity and the nature of the feeding vessels were defined in the rest 20 cases. The AVM was supplied by the anterior spinal artery in 10 cases, by posterior spinal arteries in the 4 cases, and by both the anterior and posterior spinal arteries in 6 cases. By superselective catheterization, the embolization of the feeding artery was performed in 12 cases. Among the 12 cases, three patients were clinically cured, 4 markedly effectively, 3 effectively, 2 ineffectively. The cured and marked effective rate was 58.3%. There were no severe complacations during embolization. Conclusion: Transcatheter embolization is an effective and safe therapeutic method for intramedullary AVM when angiography and superselective catheterization are perfectly done.