64层螺旋CT血管成像诊断脊髓血管畸形的价值

目的 探讨64层螺旋CT 血管成像(CTA)对脊髓血管畸形的诊断价值.方法 经临床和MR检查拟诊为脊髓血管畸形的15例患者进行了CTA.所有患者均在1周内进行了DSA检查.其中4例行于术治疗.将CTA图像与DSA和手术所见进行对照,从判定畸形的类型、显示病变累及的范围、供血动脉、引流静脉和可能存在的瘘口等方面,对CTA图像进行评价.结果 15例脊髓血管畸形经DSA和手术确诊,分别为6例髓内动静脉畸彤、2例髓周动静脉瘘、3例硬脊膜动静脉瘘和4例Cobb综合征.CTA对15例患者的分类和对病变累及范围的判断与DSA结果一致.CTA清晰显示了病变的主要供血动脉和引流静脉.5例动静脉瘘中4例CTA判断的瘘口位置与DSA所见一敛,另1例为复杂血管畸形,瘘口难以辨别.CTA还清晰显示了4例Cobb综合征位于椎旁和皮下的畸形血管团.结论 64层螺旋CTA可以判定脊髓血管畸形的类型,快速、无创地显示其主要病变特征,可作为该病的筛查手段.

The value of 64-slice CT angiography in diagnosing spinal vascular malformations

Objective To evaluate 64-slice CT angiography in diagnosing spinal vascular malformations. Methods Fifteen patients,who were suggestive of spinal vascular malformations bv clinical manifestation and MRI,underwent CT angiography with a 64-slice spiral CT(GE lightspeed VCT).DSA were performed later within 1 week in all the patients and four of them were treated with operation as well.We evaluated CTA images in displaying the lesions according to the following aspects:the type of malformation,lesion range,feeding artery,draining vein and possible fistula.and compared those details with DSA and operation findings.Results All 15 patients acquired their final diagnosis by DSA and operation,which were intramedullary axteriovenous malformation in 6 cases,perimedullary arteriovenous fistula in 2,spinal dural arteriovenous fistula in 3 and Cobb syndrome in 4 cases. CTA was consistent with DSA in the classification of lesions and in the determination of the involved regions and it reveaIed the main feeding arteries and draining veins in all patients.CTA showed four arteriovenous fistulae confinned bv DSA.but it failed in a complex arteriovcnous fistula.In Cobb syndrome patients,not only the intramedullary but also paravertebral and subcutenous vascular malformation could be clearly seen on CTA images.Conclusion 64-slice CT angiography can be a preliminary method in spinal vascular malformation because it can determine the classification and reveal almost all the main lesions quickly,atraumatically.