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作 者:邓钢[1] 黄祥龙[2] 陈星荣[2] 米岚[1] 扬维新 翟凌云[1]
机构地区:[1]云南省第一人民医院,650032 [2]复旦大学医学院华山医院
出 处:《中国医学计算机成像杂志》2000年第5期333-336,共4页Chinese Computed Medical Imaging
摘 要:目的:分析研究脊髓血管畸形的临床特征与影像学分类的相关关系。材料和方法:收集了62例经M RI、DSA和(或)手术病理证实的髓血管畸形患者,其中髓内隐匿型动静脉畸形(AVMS) 13例、球形AVMs 5例、幼稚型AVMS 12例:髓周膜内动静脉瘘(AVF) I型 Ⅱ例、血型 12例、 Ⅲ型 7例;硬膜型 AVF8例。结果:脊髓 AVMs中,隐匿型AVMs无明显的性别差异,余各类型男性均多于女性;髓内AVMS、髓周AVF以青少年多见,硬膜型AVF发生于中老年;髓内AVMs多见于颈髓及胸腰段脊髓,髓周AVF及硬膜型AVF多见于胸腰段;髓内AVMs以急性起病多见,髓周AVF表现为进行性加重,少数可急性发作,硬膜型AVF以慢性起病多见;髓内出血者预后较无出血者差。结论:根据临床症状、起病特征可初步判断病变类型,争取早期正确诊断、早期治疗,为减轻临床症状提供条件。Purpose: To study the correlation between clinical features and imaging classification of spinal vascular malformations(VMs). Materials and Methods: Of 62 patients with spinal AVMs which confirmed by MRI, DSA and/ or pathology, 30cases had intramedullary AVMs(13 occult AVMs, 5 glopular AVMs, and 12 juvenile AVMs) , 24 cases had perimedullary AVF (5 type I ) 12 type Ⅱ ) and 7 typsⅢ ) , and 8 cases had dural AVF. Results: The male patients appeared more than females in spinal cord AVMs, but the occult intramedullary AVMs had the same morbidity The patients with intramedullary AVMs and perimdeullary AVF were younger, in contrast, patients with dural AVF were usually older than 40 years of age. The intra - medullary AVMs were most common located in the cervical and thracic - lumbar spinal cord, the perimedullary AVF and dural AVF were most seen in the low thracic of lumbar region. The most common initial symptom associated with intramedullary lesions was accute onset where as the pro- gressive aggravation was the most common presenting symptom in cases of dural AVF. The prognosis of the patients with intramedullary lesions had hemorrhage was worse than who without hemorrhage. Conclusion: According to typical symptoms and clinical features, early diagnosis of types of spinal cord AVMs should be suggested, suitable examination and therapeutic methods should be taken as early.
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