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  

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

作　　者：秦杰[1] 杨铭[1] 潘力[1] 蔡明俊[1] 刘鹏[1] 杨柳[1] 安学峰[1] 马廉亭[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2015年第5期257-261,共5页Chinese Journal of Clinical Neurosurgery

摘　　要：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。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.

关 键 词：硬脊膜动静脉瘘 最大密度投影成像 双容积成像 双容积动态成像 

分 类 号：R744.1[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]