脑动静脉畸形影像学特点与治疗分析

目的:探讨脑血管畸形的临床影像学特点和治疗方法。方法:对30例经脑血管造影证实的脑动静脉畸形(AVM)的影像学及治疗资料进行回顾性分析。结果:临床以脑出血发病23例,癫痫发病5例,头痛头晕发病2例;AVM病灶位于大脑半球28例,小脑1例,基底节区1例;病灶>6cm9例,3～6cm17例,<3cm4例。10例应用NBCA胶,20例应用GLUBRAN2胶血管内栓塞。血管内栓塞后手术5例,γ-刀治疗16例。血管完全栓塞8例,栓塞90%以上13例,部分栓塞9例。随访完全栓塞8例中2例复发,不全栓塞22例中病灶扩大5例,7例病灶明显缩小,6例病灶消失。结论:血管内栓塞脑血管畸形是一种安全,有效的治疗手段,血管内栓塞结合显微手术,立体定向放射治疗能提高重要功能区和巨大动静脉畸形的治愈率。

The characters of images and treatment for cerebral arteriovenous malformations

Objective：To investigate the image features and treatment of cerebral arteriovenous malformation. Methods： Retrospective analysis was performed in 30 cases with brain arteriovenous malformation confirmed by radiograph. Results：23 patients presented with brain hemorrhage, 5 patients with epilepsy and 2 patients with headache. 28 cases AVM located in the cerebrum, 1 case in the cerebellum and 1 case in the basal ganglia. 10 cases were received embolization with NBCA and 20 patients with GLUBRAN2, 5 cases were treated by embolization combined with surgical resection, 16 cases were treated byγ-knife radiation. The overall size of the AVMs nidus was messured, 〉6cm in 9 cases, 3-6cm in 17cases,〈3cm in 4cases. 8 cases were completed obliterated, effectively obliteration in 13 cases, partly embolization in 9 cases. The results of follow up were 2 cases recurred in completed embolization, 5 cases expanded, 7 cases reduced and 6 cases disappeared in partly embolization. Conclusion：Endovascular embolization is a safe and effective method for AVMS treatment. Giant volume or important functional areas AVMs should be treated by endovascular embolization combined with surgical resection or γ-knife radiation.