320排动态容积CTA诊断脊髓血管畸形的价值  

Value of 320-row CT angiography to the diagnosis of spinal vascular malformations

作　　者：邹佳妮[1] 黄文才[1] 陈信坚[1] 吴倩[1] 陆然 马廉亭[2] 杨铭[2] 向伟楚[2] ZOU Jia-ni;HUANG Wen-cai;CHEN Xin-jian;WU Qian;LU Ran;MA Lian-ting;YANG Ming;XIANG Wei-chu(Department of Radiology, Wuhan General Hospital, PLA, Wuhan 430070, China;Department of Neurosurgery, Wuhan General Hospital, PLA, Wuhan 430070, China)

机构地区：[1]中国人民解放军武汉总医院放射科,武汉4300070 [2]中国人民解放军武汉总医院神经外科,武汉4300070

出　　处：《中国临床神经外科杂志》2017年第12期814-818,共5页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨320排动态容积CTA对脊髓血管畸形的诊断价值。方法 2013年1月至2016年6月应用320排动态容积CTA共诊断脊髓血管畸形20例,其中16例CTA检查后1周内行DSA检查。结果同时完成CTA和DSA检查的16例脊髓血管畸形中,10例CTA与DSA获得的诊断相符,包括髓内动静脉畸形2例、髓周动静脉瘘3例和硬脊膜动静脉瘘5例。2例髓周动静脉瘘在CTA显示的供血动脉(1例)、病变范围(1例)与DSA不符;3例硬脊膜动静脉瘘在CTA未显示供血动脉,其中2例在DSA未显示异常血管结构;1例海绵窦硬脑膜动静脉瘘在CTA被误判为髓内动静脉畸形。结论 320排动态容积CTA可作为筛查脊髓血管畸形的重要手段,但CTA可能遗漏小的供血动脉,或因扫描范围受到限制有可能导致脊髓血管畸形类型的误判。Objective To investigate the diagnostic value of320-row CT angiography(320-CTA)for the diagnosis of spinal vascular malformations(SVMs).Method Twenty patients with SVMs indicated by320-CTA underwent digital subtraction angiography(DSA)a week after320-CTA.The outcomes of320-CTA were compared with those of DSA in16patients.Result Of16patients with SVMs receiving both320-CTA and DSA,10patients,including2patients with inner-medullary arteriovenous malformations (IMAVMs),3with peri-medullary arteriovenous fistula(PMAVFs)and5with spinal dural arteriovenous fistula(SDAVFs),had similar diagnoses made by320-CTA and DSA and6had different diagnoses,including2in whom the feeding arteries and lesions extent displayed by320-CTA were not consistent with those displayed by DSA,3with SDAF in whom the feeding arteries were not displayed by320-CTA and DSA showed no abnormal vessels in2and1with cavernous sinus dural arteriovenous fistula diagnosed by DSA in whom IMAVM was suspected by320-CTA.Conclusion It is suggested320-row dynamic CT is a valuable method to screen out SVMs,but the small feeding artery is sometimes ignored by320-CTA,and the misdiagnosis of vascular malformation may be induced by320-CTA due to limited scanning range.

关 键 词：脊髓血管畸形 320排动态容积CT血管成像 DSA 诊断 

分 类 号：R744.1[医药卫生—神经病学与精神病学] R455.3[医药卫生—临床医学]