动态容积CT血管成像在颅内硬脑膜动静脉瘘诊断中的应用价值  

Application value of dynamic volume CT angiography in the diagnosis of intracranial dural arteriovenous fistula

作　　者：应潇瑜 黄景峰[2] 沈芳杰 郑晓东 潘宇宁[2] YING Xiaoyu;HUANG Jingfeng;SHEN Fangjie;ZHENG Xiaodong;PAN Yuning(Department of Radiology,Ningbo First Hospital,Ningbo University School of Medicine,Ningbo,Zhejiang Province 315211,China;Department of Radiology,Ningbo First Hospital,Ningbo,Zhejiang Province 315000,China)

机构地区：[1]宁波大学医学院附属宁波市第一医院影像科,浙江宁波315211 [2]宁波市第一医院医学影像科,浙江宁波315000

出　　处：《实用放射学杂志》2022年第1期18-21,共4页Journal of Practical Radiology

基　　金：浙江省医药卫生科技计划项目(2018KY155)。

摘　　要：目的探讨动态容积CT血管成像(CTA)在硬脑膜动静脉瘘(DAVF)诊断、定位及分型中的应用价值.方法81例DAVF患者行动态容积CTA及数字减影血管造影(DSA)检查,2次检查间隔时间<14 d.所有图像以DSA作为金标准,由2位放射科医师对病灶定位及分型进行独立的评估,并对图像质量进行分级,分型参照Congard标准.结果81例动态容积CTA重建图像中,72例图像质量为Ⅰ级,其余9例图像质量为Ⅱ级.81例患者中位置分布分别为:硬膜窦区(43例)、海绵窦区(23例)、天幕区(8例)、基底静脉丛区(4例)和大脑镰区(3例).根据动态容积CTA图像Congard标准分型结果为:Ⅰ型30例,Ⅱa型4例,Ⅱb型15例,Ⅱa+b型2例,Ⅲ型11例,Ⅳ型17例,Ⅴ型2例.其中78例分型结果与DSA一致,3例与DSA不符.结论动态容积CTA在DAVF无创性诊断、定位及分型上与DSA一致性较好,可为临床提供判断疾病风险的依据.Objective To explore the application value of dynamic volume CT angiography(CT A)in the diagnosis,locati on and classification of dural arteriovenous fistula(DAVF).Methods Dynamic volume CTA and digital subtraction angiography(DSA)were performed in 81 patients with DAVF.The interval between two examinations was less than 14 days.All images were evaluated independently by 2 neuroradiologists using DSA as the gold standard for location and classification,and the image quality was graded.The classification was based on Congard standard.Results Among the 81 cases of dynamic volume CTA images,72 cases were grade I,and the other 9 cases were gradeⅡ.The location distributions of 81 patients were:dural sinus area(43 cases),cavernous sinus area(23 cases),basal tentorium area(8 cases),venous plexus area(4 cases)and cerebral falx area(3 cases).According to the Congard standard,the results of dynamic volume CTA images were:30 cases of typeⅠ,4 cases of typeⅡa,15 cases of typeⅡb,2 cases of typeⅡa+b,11 cases of typeⅢ,17 cases of typeⅣand 2 cases of type Ⅴ.The typing results were consistent with DSA in 78 patients,but not in 3 patients.Conclusion Dynamic volume CTA is consistent with DSA in noninvasive diagnosis,location and classification of DAVF,which can provide a basis for clinical risk judgment of the disease.

关 键 词：硬脑膜动静脉瘘 计算机体层成像 血管造影术 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]