对比增强MRA鉴别脊髓血管畸形及脊髓非血管畸形所致继发性血管纡曲  

Contrast-enhanced MRA in differential diagnosis of spinal cord vascular malformation and secondary vascular tortuosity caused by non vascular malformations on spinal cord

作　　者：葛宇曦[1] 孙宗琼[1] 汪洋[1] 李青海 延根[1] GE Yuxi;SUN Zongqiong;WANG Yang;LI Qinghai;YAN Gen(Department of Radiology,Affiliated Hospital of Jiangnan University,Wuxi 214000,China;Department of Radiology,the Second Affiliated Hospital of Zhejiang UniversitySchool of Medicine,Hangzhou 310009,China)

机构地区：[1]江南大学附属医院影像科,江苏无锡214000 [2]浙江大学医学院附属第二医院放射科,浙江杭州310009

出　　处：《中国医学影像技术》2018年第6期860-864,共5页Chinese Journal of Medical Imaging Technology

基　　金：江南大学公共卫生研究中心2015年立项项目(JUPH201509)

摘　　要：目的评价CE-MRA脊髓造影鉴别脊髓血管畸形(SCVM)和脊髓非血管畸形所致继发性血管纡曲的价值。方法回顾性分析30例CE-MRA疑诊SCVM患者资料,根据DSA或手术结果分为SCVM组(16例)及脊髓非血管畸形组(14例),对比分析2组CE-MRA脊髓纡曲血管的数量、长度、位置、纡曲程度及纡曲血管周围是否存在异常供血动脉差异。结果与脊髓非血管畸形组比较,SCVM组脊髓纡曲血管数量更多[(1.38±0.16)支vs 1支,P=0.012],纡曲血管长度更长[(9.68±1.18)个椎体vs(4.14±0.62)个椎体,P<0.001],血管纡曲程度评分更高[(2.23±0.22)分vs(0.86±0.10)分,P<0.001),且纡曲血管周围存在异常供血动脉比例更高[75.00%(12/16)vs 28.57%(4/14),P=0.014]。SCVM组仅2例(2/16,12.50%)血管纡曲局限于下胸椎段(T7～T12椎体),而脊髓非血管畸形组11例(11/14,78.57%)局限于下胸椎段(T7～T12椎体),2组间纡曲血管位置差异有统计学意义(P=0.020)。结论CE-MRA脊髓血管造影可鉴别SCVM与脊髓非血管畸形引起的继发性血管纡曲。Objective To observe the value of CE-MRA in differentiating secondary vascular tortuosity of the spinal cord caused by spinal vascular malformations（SCVM）or non-vascular malformations.Methods A retrospective analysis was performed on 30 patients suspected as SCVM.Based on the results of DSA or surgery,the patients were divided into SCVM group（n=16）or non-vascular malformation group（n=14）.CE-MRA features were compared between the two groups,including the number,length,position,tortuosity degree of spinal cord tortuous vascular and whether the abnormal feeding artery existed surrounding tortuous vascular.Results Compared with non-vascular malformation group,SCVM group showed more average number of tortuous vascular [（1.38 ± 0.16）vs 1,P=0.012],longer tortuous vascular lengthy[similar lengthy of（9.68 ± 1.18）vertebral body vs（4.14±0.62）vertebral body,P〈0.001）,higher score of tortuosity degree[（2.23± 0.22）scores vs（0.86±0.10）scores,P〈0.001]and more easier to appear abnormal feeding artery surrounding tortuous vascular[75.00%（12/16）vs 28.57%（4/14）,P=0.014].Furthermore,only 2 cases（2/16,12.50%）of tortuous vascular located in and limited to lower thoracic vertebra（T7—T12 vertebrae）in SCVM group,while 11 cases（11/14,78.57%）in non-vascular malformation group（P =0.020）.Conclusion Spinal cord secondary vascular tortuosity of SCVM can be well distinguished from that caused by non-vascular malformation with CEMRA spinal angiography.

关 键 词：磁共振血管造影术 脊髓 血管畸形 动静脉瘘 脊髓炎 血管纡曲 

分 类 号：R543[医药卫生—心血管疾病] R445.2[医药卫生—内科学]