最大密度投影、双容积及双容积动态成像对硬脊膜动静脉瘘诊治的研究

目的 探讨最大密度投影、3D-DSA/Dyna-CT双容积及双容积动态成像对硬脊膜动静脉瘘诊断及手术的应用价值。方法 对8例硬脊膜动静脉瘘患者术前均行最大密度投影、3D-DSA/Dyna-CT双容积和双容积动态成像，协助术前诊断、判断瘘口的部位、供血动脉与椎间孔的关系、引流静脉所在椎管内的部位，然后手术灼闭瘘口。结果 最大密度投影冠状位、矢状位和轴位成像、3D-DSA/Dyna-CT双容积成像、双容积动态成像可使硬脊膜动静脉瘘的供血动脉、瘘口位置、引流静脉与其毗邻的椎间孔、棘突、上下椎体的空间三维解剖关系清晰的显现，弥补了单一3D-DSA、MRA、CTA等影像的不足，不仅可在术前协助诊断，模拟手术入路，而且可指导手术过程的顺利进行，有效的避免并发症的发生，取得良好临床效果。结论 双容积与双容积动态成像，尤其是最大密度投影成像对硬脊膜动静脉瘘的诊断、治疗有较大的应用价值。

Application of maximum intensity projection,double volume imaging and dynamic double volume imaging to diagnosis and treatment of the spinal dural arteriovenous fistulas

Objective To explore the value of maximum intensity projection, 3D-DSA/Dyna-CT double volume imaging and dynamic double volume imaging to diagnosis and treatment of the spinal dural arteriovenous fistulas (SDAVF). Methods The maximum intensity projection imaging, 3D-DSA/Dyna-CT double volume imaging and dynamic double volume imaging were performed before the surgery in 8 patients with SDAVF in order that SDAVF were definitely diagnosed as, and the fistula site, the relationship between the feeding arteries and intervertebral formen and the intravertebral position of the draining veins were clarified. Results The SDAVF feeding arteries, fistula sites and draining veins, and the anatomical relationship among the intervertebral foramina, spinous processes and vertebral bodies were clearly shown by the maximum density projection coronal, sagittal and axial imaging, 3D-DSA/Dyna-CT double volume imaging and dynamic double volume imaging, which made up the deficiency of the informations provided by a single 3D-DSA, or MRA, or CTA, or other imaging. The fistulas were successfully closed and there were not any operative complications in all the patients. Conclusion The double volume imaging and double volume dynamic imaging, especially the maximum intensity projection imaging are of the great value to diagnosis and treatment of SDAVF.