硬脊膜动静脉瘘磁共振成像的特点  

MRI characteristics of spinal cord lesions in patients with spinal dural arteriovenous fistula

作　　者：杨丕丕[1] 高勇安[1] 石巍巍[1] 张鸿祺[2] 凌锋[2] 

机构地区：[1]首都医科大学宣武医院放射科,北京100053 [2]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国脑血管病杂志》2008年第11期509-513,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金资助项目(30772236);北京市科技新星资助项目(2004B37)

摘　　要：目的分析硬脊膜动静脉瘘(SDAVF)脊髓病变的MRI特点,探讨脊髓病变与畸形血管和临床症状的关系。方法经DSA证实的SDAVF患者32例,应用场强3.0T超导型MRI扫描仪于术前行常规脊髓MRI平扫和增强扫描。按照脊髓病变的范围,分为局限(1～4个椎体)、中度(5～7个椎体)和广泛(8～10个椎体)病变三组。按照改良的Aminoff和Logue步态与排尿障碍法,于术前对患者进行临床评分,<6分为轻症者,≥6分为重症者。结果①30例病变中心位于下胸段(94%,30/32)。32例中病变局限组8例(25%),临床轻症者6例,重症者2例;中度组19例(59%),临床轻症者5例,重症者14例;广泛组5例(16%),轻症者1例,重症者4例。②32例患者髓内均可见T2WI高信号,31例高信号位于脊髓中心,呈"铅笔样"改变,1例呈弥散状分布;2例髓内可见T1WI低信号。增强扫描后,31例脊髓强化,1例未见强化。③瘘口位于脊髓病变范围内12例,位于脊髓病变范围外20例。④31例引流静脉范围≥相应脊髓病变范围,且引流静脉与脊髓病变部位一致;1例脊髓病变>引流静脉范围,引流静脉与脊髓病变部位部分一致。结论①SDAVF脊髓病变范围广泛、多位于下胸段,病变范围与临床症状严重程度有一定关系,但临床症状相对轻。②MRI上多表现为沿脊髓中心走行的铅笔样T2WI高信号,T1WI低信号少见。③SDAVF脊髓病变部位与瘘口常不一致。④SDAVF异常引流静脉与脊髓病变分布一致,且通常大于脊髓病变范围。Objectives To analyze the MRI characteristics of spinal cord lesions in patients with spinal dural arteriovenous fistula(SDAVF)and to investigate the correlation between myeleterosis and malformed vessels and clinical symptoms.Methods Thirty-two patients with SDAVF were confirmed by digital subtraction angiography.Conventional MRI scan and enhanced scan of spinal cord were performed using a 3.0T magnet system before surgery.According to the range of spinal lesions,the patients were divided into 3 groups:the...

关 键 词：磁共振成像 脊髓疾病 硬脊膜动静脉瘘 

分 类 号：R445.2[医药卫生—影像医学与核医学]